Innovative approaches in the treatment of the uterine myoma to restore reproductive function

Abstract

Aim: Uterine myoma (UM) is the most common benign tumor of the uterus and is found in 20–40% of women of reproductive age, thus significantly reducing the reproductive function of women. UM is still treated surgically, and is the most common cause of hysterectomy.

Methods: The study included 234 patients at the age of 29–45 years, who had UM, who have been treated by the drug group of selective progesterone receptor modulators (SPRM) of ulipristala acetate 5?mg for three months. Women were scheduled for surgery.

Results: One hundred and forty-one (60.3%) of women had amenorrhea in 7–9 days. A clear reduction of anemia appeared after the treatment (mild degree – 108 (46.2%) women, 126 (53.8%) of women had a normal level of hemoglobin, p?>?0.05).

The mean value of the uterine size reduction was 30.7% (min – 8%, from 425 to 391?cm³, maximum – 78%, from 1282 to 282?cm³); MM – 27.8% (min 12%, from 285 to 251?cm³, max 55%, from 949 to 427?cm³). In 54 (23.1%) women size of the uterus and fibroids has not changed. Two hundred and sixteen (92.3%) patients were successfully performed laparoscopy, myomectomy. Eighteen (7.7%) patients avoided surgery after treatment, p?>?0.05.

Conclusions: An innovative approach in the use of ulipristala acetate led to a significant regression of the UM, which allowed for the surgical treatment with a minimal impact on the uterus, improving the reproductive prognosis.