A modern scheme for preserving treatment of uterine leiomyoma
A.L. Tikhomirov, D.M. Lubnin
Department of Obstetrics and Gynaecology, Moscow State Medical and
Stomatological University, Russia
Considering (1) the results of our previous research which demonstrated
inhibitory effect of oral contraceptives Novynette on further growth of fibroids
less than 2 cm in size as well as (2) existing data on reduction of risk of
leiomyoma development due to prolonged oral contraceptives administration and
(3) effectiveness of uterine arteries embolization we have developed a
preserving treatment scheme for patients with leiomyoma. Fibroids 10 to 20 mm in
size – prolonged oral contraceptives administration. Fibroids 10 to 20 mm in
size – 2-stage treatment: GnRH agonists for 12–24 weeks followed by
prolonged oral contraceptives administration. Fibroids over 45 mm in size –
uterine arteries embolization (myomectomy in case of a single fibroid in a
nonparous woman). Subserosal pedunculated fibroids – laparoscopy. Submycosal
fibroids – hysteroresectoscopy for sizes up to 30 mm, uterine arteries
embolization for larger sizes. 3560 patients have been treated using the scheme
in the course of 3 years and only 12 of them have had to undergo hysterectomy
which makes just 0,3%. Therefore we can maintain our scheme lets treat leiomyoma
preserving organs and reducing need for surgery considerably.
