USE OF ANTIPROGESTINS TO PREVENT RELAPSES AFTER CONSERVATIVE MYOMECTOMY

Objective. To evaluate the efficacy and safety of antiprogestins versus gonadotropin-releasing hormone agonists in adjuvant therapy after conservative myomectomy. Subjects and methods. Sixty-nine reproductive-age women with uterine myoma underwent enucleation of myomatous nodules by laparotomic, laparoscopic, or transcervical access. To prevent recurrent myoma, Group 1 patients were given the antiprogestin mifepristone (50 mg daily for 4 months); Group 2 was administered gonadotropin-releasing hormone agonists (triptorelin or leuroprorelin 3.75 mg as a single intramuscular injection every 28 days for 6 months); Group 3 women used oral contraceptives after surgery. Transvaginal echography and Doppler study were regularly performed during 2 years. Results. The recurrence rate of uterine myomas was significantly lower in the group of patients receiving adjuvant therapy than in those taking oral contraceptives (8.6 and 34.7%, respectively). Conclusion. Postoperative adjuvant therapy with mifepristone or gonadotropin-releasing hormone agonists significantly reduces the risk of recurrent uterine myoma; moreover, the antiprogestin drug shows fewer adverse events and better tolerability.

uterine myoma, recurrent myoma after conservative myomectomy, mifepristone, gonadotropin-releasing hormone agonists