• Clinical experience of using GnRH agonists in the treatment of uterine leiomyoma with concomitant gynecological pathology

Clinical experience of using GnRH agonists in the treatment of uterine leiomyoma with concomitant gynecological pathology

HEALTH OF WOMAN. 2018.10(136):22–25; doi 10.15574/HW.2018.136.22

Kaminskiy V. V. , Prokopovych E. V.
Shupyk National Medical Academy of Postgraduate Education, Kiev 
Kyiv City Center for Reproductive and Perinatal Medicine
PI «Novomoskovsk Central City Hospital», Novomoskovsk

The objective: evaluation of the effectiveness of the use of GnRH agonists in the treatment of uterine fibroids on the background of combined gynecological pathology.

Materials and methods. A comprehensive examination and treatment of 40 women aged 20–49 years with uterine myoma on the background of combined gynecological pathology (endometrial hyperplastic processes, endometriosis, infertility, diffuse fibrocystic mastopathy) were carried out. Patients were divided into two groups, 20 each. In the main group, women received buserelin acetate 3.75 mg in the form of a suspension for parenteral administration for 2–6 months. In the comparison group, 20 women were subjected to surgical treatment for similar indications, but they did not prescribe buserelin acetate before the operation. The observation period for women was 24 months.

Results. After the use of buserelin acetate, a decrease in the severity of all clinical symptoms was noted in comparison with the initial data, the ultrasound and X-ray picture. When carrying out a comparative characteristic of the course of endoscopic operations, a decrease in the duration of conservative myomectomy and subtotal hysterectomy with a simultaneous decrease in intraoperative blood loss is evident.

Conclusion. The use of GnRH agonists in the treatment of uterine leiomyoma on the background of combined gynecological pathology is highly effective and promising as an independent and complex method of therapy.

Key words: uterine myoma, endometriosis, GnRH agonists, buserelin acetate, endometrial hyperplastic processes, fibrocystic mastopathy.

REFERENCES

1. Kornatska AH, Ivaniuta IS. (2012). Vidnovlennia reproduktyvnoi funktsii pislia kombinovanoho likuvannia iz zastosuvanniam dyferelinu u khvorykh z leiomiomoiu matky. Zdorove zhenshchynу 1:199–200.

2. Medvediev MV. (2012). Leiomioma matky: novi pidkhody do zastosuvannia orhanozberihaiuchykh tekhnolohii v likuvanni. Medychni perspektyvy 17;3:83–87.

3. Tatarchuk TF, Kosei NV. (2012). Sovremennуe pryntsypу lechenyia leiomyomу matkі. Zdorovia Ukrainy. Tematychnyi nomer: 10–13.

4. Popov AA, Maganskite OV, Manannikova TN. (2014). Hirurgicheskoe i medikamentoznoe lechenie bolnyih reproduktivnogo vozrasta s miomoy matki. Russ. vestnik akushera-ginekologa 14;5:111–114.

5. Nosenko EN, Skidanova EA. (2013). Progesteron i leyomioma matki. Mediko-sotsialnyie problemyi semi 18;3:105–110.

6. Baylyuk EA, Aylamazyan EK, Semiglazov VF. (2008). Kliniko-morfologicheskie osobennosti proliferativnyih protsessov v molochnoy zheleze u zhenschin s miomoy matki. Zdorove zhenschiny 36;4:33–37.

7. Cook H, Ezzati M, Segars JH, McCarthy K. (2010). The impact of uterine leiomyomas on reproductive outcomes. Minerva Ginecologica. 62;3:225–236. PMid:20595947 PMCid:PMC4120295

8. Hauptmann S, Kohler G. (2014). Etiology, Pathogenesis, and Malignant Potential of Uterine Leiomyoma – A Review. Curr Obstet Gynecol Rep. 3:186–190. https://doi.org/10.1007/s13669-014-0091-x

9. Stovall Dale W. (2011). Alternatives to hysterectomy: focus on global endometrial ablation, uterine fibroid embolization, and magnetic resonance-guided focused ultrasound. Menopause. 4;18:443–450. https://doi.org/10.1097/gme.0b013e318207fe15; PMid:21701430

10. Radosa MP, Owsianowski Z, Mothes A. (2014). Long-term risk of fibroid recurrence after laparoscopic myomectomy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 180:35–39. https://doi.org/10.1016/j.ejogrb.2014.05.029; PMid:25016181