Preoperative preparation of women with uterine myoma
Liudmila Hutsikava (BY), Yuliya Kukharchyk (BY)
[Hutsikava] Grodno state medical univercity, [Kukharchyk] Grodno state medical univercity
Uterine fibroids is one of the main causes of abnormal uterine bleeding, iron deficiency anemia, urinary disorders, pelvic pain, reduced fertility, miscarriage, which significantly affects the quality of women life. Materials and methods. The research included 26 patients aged from 37 to 42 years with uterine myomas. The treated group of 16 patients received ulipristal acetate 5 mg/day for 3 months as a pre-surgical treatment. The control group of 10 patients with uterine myoma received no treatment. Нistological examinations consisted of immune histochemical tests; markers of cellular proliferation (Ki-67 and VEGF). Results. After a 3-month course of ulipristal acetate therapy in the treated group, the main sizes of the uterine myomas decreased by 3,1 cm. The size of the dominant myoma was reduced on average by 3±0,6 cm in diameter. The thickness of the endometrium before the treatment by ultrasound on day 5 of the menstrual cycle was 11 mm after the treatment – 7,5 mm. There were reveled sclerosis and hyalinosis perivascular cell leiomyoma growth zone after ulipristal acetate treatment, and the next one shows large numbers of myoma cells in apoptosis after 3-month treatment with ulipristal acetate. Immune histochemical examination showed that Ki-67 was introduced by single cells. The profound and statistically significant reduction of proliferation by 34,3% was observed in the group after the treatment. VEGF had a weak-to-moderate expression in comparison with non-treated group. In the treated group the expression of the progesterone receptors was 10 % higher than in the control group. Estrogen expression in compered groups hadn’t differ significantly. Conclusion. The decrease of proliferation and hypertrophy of smooth muscle cells of uterine myomas, under the treatment with ulipristal acetate, was reported, without any adverse effects on the surrounding myometrium.