New views on the treatment of uterine leiomyoma in women of reproductive age

Abstract

Uterine leiomyoma is the most common reproductive system disease in women of fertile age, which takes the leading place in frequency among tumors of the female sexual sphere. It is diagnosed in 20–70% of women of reproductive age. The uterine leiomyoma is still often treated surgically, and is the most common cause of hysterectomies. The article examines the issues of increasing the effectiveness of treatment of uterine leiomyoma and its complications in women of reproductive age by using combined methods of conservative treatment. The results of examination and treatment of 55 patients aged 27–45 with different forms of leiomyoma are presented: intramural nodes (18–32.7%), intramuralsubserous (21–38.3%) and intramural-submucous (16–29.0%). The size of the dominant node varied from 4.5 to 12 cm. Clinical manifestations of leiomyoma was hyperpolimenorrhea (82.3%), lower abdominal pain (34.7%), frequent urination (15%). Also, 86% of women suffered from a decrease in hemoglobin in the blood. In respect of all patients, organ-preserving surgical treatment was planned in connection with the desire of women to giving birth to a child. Patients took ulipristal acetate in a continuous regimen of 5 mg per day and indole-3-carbinol with epigallocatechin-3-gallate 1 tablet 2 times a day for 12 weeks. Women with anemia concurrently with this basic therapy took iron preparations inside. 43 (78.3%) women had amenorrhea since the beginning of treatment within a month. The mean decrease in the size of the uterus was 40.7%. After the end of treatment, 49 (89.0%) patients successfully underwent conservative myomectomy, and in 6 (11.0%) patients after the termination of treatment surgical intervention was avoided. During the year after the termination of the course of treatment 13 women became pregnant. In using the combination therapy with ulipristal acetate in combination with indole-3-carbinol and epigallocatechin-3-gallate for 3 months the hemoglobin level was normalized, and the size of the leiomyoma was decreased, which is important for the safe operation. This therapy is a method of choice for the treatment of young women, who intend to exercise their reproductive function.

Keywords

• uterine leiomyoma
• infertility
• combined therapy