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№2' 2016

OBSTETRICS AND GYNECOLOGY

International Medical Journal, Vol. 22., Iss. 2, 2016, P. 43−46.

MODERN APPROACHES TO TACTICS OF MANAGEMENT OF PATIENTS WITH MYOMA UTERUS

Kharkiv National Medical University, Ukraine

Differentiated use of organ operations in gynecological patients with uterine leiomyoma (UL) allows saving generative function of patients. In this context, the aim of our study was to evaluate the effectiveness of the combined treatment and various types of hormonal therapy in patients with UL. The study involved 48 women with UL, who were divided into two clinical groups: 1 (n = 20) treated with combination therapy: stage 1 −− hormone therapy with Gn−RG agonists for 3 months. In the absence of the effect of the therapy, stage 2 (operation) was performed: laparotomy, myomectomy with histological examination of the removed tissue. Group 2 consisted of 28 patients who received preoperative selective modulators of receptors by estrogen for 3 months. Treatment efficacy was assessed by the change in the size of fibroids, normalization of the general condition and uterine bleeding intensity. The investigation demonstrated that the use of hormone therapy in some cases allows avoiding surgical treatment to stabilize the growth of fibroids and significant reduce their size. In case of ineffective hormonal therapy, surgery was performed. The use of hormone replacement therapy in the preoperative stage allowed to increase the percentage of organ−preserving operations, to reduce blood loss during surgery and to reduce the size of the scar on the uterus.

Key words: uterine leiomyoma, hormone therapy, surgery.