کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3919644 | 1599789 | 2015 | 5 صفحه PDF | دانلود رایگان |
ObjectiveTo compare the usefulness of preoperative treatment with triptorelin, letrozole or ulipristal acetate or no treatment before hysteroscopic removal of uterine submucosal myomas.Study designSingle center prospective non-randomized comparative pilot study. The study included consecutive premenopausal patients undergoing hysteroscopic resection of myomas graded as type 0, type 1 or type 2 according to the FIGO classification with diameter between 20 and 35 mm. Exclusion criteria were: associated polyps, associated non-hysteroscopic surgical procedures, >2 myomas requiring hysteroscopic resection. This study enrolled patients who underwent either direct surgery (group S; n = 23) or 3-month preoperative treatment with triptorelin (3.75 mg every 28 days; group T; n = 20), letrozole (2.5 mg/day; group L; n = 11) or ulipristal acetate (5 mg/day; group U; n = 7). Patients underwent hysteroscopic resection of the myomas.ResultsAll medical treatments caused a significant decrease in the volume of myomas (group T, p < .001; group L, p < .001; group U, p = .006); however, the percentage decrease in myoma volume was lower in group U than in group T (p = .001) and in group L (p = .010). The hysteroscopy time was higher in group S than in group T (p < .001) and in group L (p = .001); there was no significant difference in the hysteroscopy time between group S and group U (p = .206). Fluid absorption was lower in group T than in group S (p = .002) and in group L than in group S (p = .048); fluid absorption was similar in group S and group U (p = .110). Intra- and postoperative complications, postoperative pain, and patient satisfaction were similar in the four study groups. Surgeon's evaluation of operative difficulty was better in group T than in group S (p < .005).ConclusionsPreoperative treatment with triptorelin and letrozole decreases the hysteroscopy time and the volume of fluid absorbed during hysteroscopic resection of uterine submucosal myomas.
Journal: European Journal of Obstetrics & Gynecology and Reproductive Biology - Volume 192, September 2015, Pages 22–26