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Better option for fibroids related infertility: in favor of surgery

Abstract

Incidence of uterine fibriods in women population is 20-25 %. At the age of 35 years the incidence increased to 52 %, but only 20 % of all fibroids became symptomatic. This article presents a modern view of conservative and surgical treatment of uterine fibroids. We study results of 721 myomectomies, which are performed at our department from 2010 to 2014 year. Laparoscopic myomectomy was done in 502 patients (69.6 %), laparotomic in 13 % cases, hysteroscopic myomectomy in 141 (19.9 %) patients. In 26 (3.6 %) cases a combined access was required, in 7 (0,97%) - a conversion. We analyzed the reproductive outcomes of 218 patients treated at our department. The cumulative frequency of pregnancies was 51.6 %. Spontaneous pregnancy accounted for 69 % of this number. A single (1.3 %) complication in the form of the uterine scar rupture was documented in the week 34 of pregnancy. Conclusion. Myomectomy in symptomatic myoma is a safety procedure with a low rate of complications.

About the Authors

A. A. Popov
Moscow Regional Research Institute for Obstetrics and Gynecology
Russian Federation


A. A. Fyodorov
Moscow Regional Research Institute for Obstetrics and Gynecology
Russian Federation


E. A. Loginova
Moscow Regional Research Institute for Obstetrics and Gynecology
Russian Federation


Т. Мананникова
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»
Russian Federation


А. Коваль
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»
Russian Federation


References

1. Актуальные вопросы акушерства, гинекологии и репродуктологии / Под ред. Е. В. Коханевич. М., 2006. 480 с.

2. Буянова С. Н., Юдина Н. В., Гукасян С. А. Реабилитация репродуктивной функции у женщин с миомой матки, страдающих бесплодием и невынашиванием беременности // Российский вестник акушера-гинеколога. 20J2. № 5. С. 67-7J.

3. Савельева Г. М., Бреусенко В. Г. Гинекология. 3-е изд. М.: ГЭОТАР-Медиа, 2007. 432 с.

4. Сидорова И. С. Миома матки. Москва: МИА, 2003. С. 256.

5. Klatsky PC, Tran ND, Caughey AB, Fujimoto VY. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. // Am. J. Obstet. Gynecol. 2008. J98 (4): Р. 357-366.

6. Carranza-Mamane B, Havelock J, Hemmings R, Cheung A, Sierra S, Case A, Dwyer C, Graham J, Liu K, Murdock W, Vause T, Wong B, Burnett M. The management of uterine fibroids in women with otherwise unexplained infertility // J. Obstet. Gynaecol. Can. 20J5; 37 (3). Р. 277-288.

7. Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. // Best Pract. Res. Clin. Obstet. Gynaecol. 20J6. № J. Р. J-8.

8. Lu N, Wang Y, Su YC, Sun YP, Guo YH. Effects of the distance between small intramural uterine fibroids and the endometrium on the pregnancy outcomes of in vitro fertilization-embryo transfer. Gynecol. Obstet. Invest. 20J5; 79.(J): 62-68.

9. Yan L, Ding L, Li C, Wang Y, Tang R, Chen ZJ. Effect of fibroids not distorting the endometrial cavity on the outcome of in vitro fertilization treatment: a retrospective cohort study. Fertil. Steril. 20J4; J0J (3): 7J6-72J.

10. Namazov A, Karakus R, Gencer E, Sozen H, Acar L. Do submucous myoma characteristics affect fertility and menstrual outcomes in patients underwent hysteroscopic myomectomy? Iran J. Reprod. Med. 20J5 Jun; J3 (6): 367-72.

11. Taylor E, Gomel V. The uterus and infertility. Fertile Steril. 2008; 89: J-J6.

12. Moroni R, Vieira C, Ferriani R, Candido-Dos-Reis F, Brito L. Pharmacological treatment of uterine fibroids. // Ann. Med. Health Sci. Res. 20J4. № 4. Р. J85-J92

13. Gemzell-Danielsson K, Marions L. Mechanisms of action of mifepristone and levonorgestrel when used for emergency contraception. Hum. Reprod. Update 2004; J0: 34J-8

14. Steinauer J, Pritts EA, Jackson R, Jacoby AF. Systematic review of mifepristone for the treatment of uterine leiomyomata. Obstet. Gynecol. 2004; J03: J33J-6

15. Senol T, Kahramanoglu I, Dogan Y, Baktiroglu M, Karateke A, Suer N. Levonorgestrelreleasing intrauterine device use as an alternative to surgical therapy for uterine leiomyoma. // Clin. Exp. Obstet. Gynecol. 20J5. № 42 (2). Р. 224-227

16. Machado RB, de Souza IM, Beltrame A, Bernardes CR, Morimoto MS, Santana N. The levonorgestrel-releasing intrauterine system: its effect on the number of hysterectomies performed in perimenopausal women with uterine fibroids. // Gynecol. Endocrinol. 20J3. № 29 (5). Р. 492-495

17. Willame A, Marci R, Petignat P, Dubuisson J. Myoma migration: an unexpected «effect» with Ulipristal acetate treatment // Eur. Rev. Med. Pharmacol Sci. 20J6; 20 (8): J439-J444

18. Puchar A, Luton D, Koskas M. Ulipristal acetate for uterine fibroid-related symptoms. // Drugs Today (Barc). 20J5. 5J (J J). Р. 66J-667

19. Luyckx M, Squifflet JL, Jadoul P, Votino R, Dolmans MM, Donnez J. First series of J8 pregnancies after ulipristal acetate treatment for uterine fibroids. Fertil. Steril. 20J4 Nov; J02 (5). P. J404-J409

20. Olejek A, Olszak-Wąsik K, Czerwinska-Bednarska A. Long-term intermittent pharmacological therapy of uterine fibroids - a possibility to avoid hysterectomy and its negative consequences. // Prz. Menopauzalny. 20J6. № J5 (J). Р. 48-5J

21. Mara M., Kubinova K. Embolization of uterine fibroids from the point of view of the gynecologist: pros and cons. // Int. J. Womens Health. 20J4 № 20 (6). Р. 623-629

22. Carpenter TT, Walker WJ. Pregnancy following uterine artery embolisation for symptomatic fibroids: a series of 26 completed pregnancies. // BJOG 2005. № JJ2 (3). Р. 32J-325

23. Lumsden MA. Embolization versus myomectomy versus hysterectomy: which is best, when? Hum. Reprod. 2002; J7: 253-9.

24. Rabinovici J, David M, Fukunishi H, Morita Y, Gostout BS, Stewart EA. Pregnancy outcome after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids. // Fertil. Steril. 20J0. № 93 (J). Р. J 99-209.

25. Hamoda H, Pepas L, Tasker F, Reidy J, Khalaf Y. Intermediate and long-term outcomes following uterine artery fibroid embolization. // Eur. J. Obstet. Gynecol. Reprod. Biol. 20J5. № J9J. Р. 33-38.

26. Arthur R, Kachura J, Liu G, Chan C, Shapiro H. Laparoscopic myomectomy versus uterine artery embolization: long-term impact on markers of ovarian reserve. // J. Obstet. Gynaecol. Can. 20J4. № 36 (3). Р. 240-247.

27. Sizzi O, Rossetti A, Malzoni M, Minelli L, La Grotta F, Soranna L, Panunzi S, Spagnolo R, Imperato F, Landi S, Fiaccamento A, Stola E. Italian multicenter study on complications of laparoscopic myomectomy. // JSLS. 2007. J4 (4). P. 453-62.

28. Савельева Г. М., Курцер М. А., Бреусенко В. Г., Каппушева Л. М., Азиев О. В., Штыров С. В., Краснова И. А., Аксенова В. Б. Эндоскопическая миомэктомия: за и против // Вопросы гинекологии, акушерства и перинатологии. 2007; 6 (J): 57-60.

29. Ушаков Ю. Э., Пругло А. К., Будак В. С., Косолапова Н. В. Случай разрыва матки во время беременности после консервативной миомэктомии без ушивания матки в анамнезе. // Таврический медико-биологический вестник. 20J3. Т. J6, № 2, ч. 2 (62). С. J66-J68.

30. Стрижаков А. Н., Баев О. Р., Рыбин М. В., Тимохина Т. Ф. Разрыв матки во время беременности после лапароскопической миомэктомии // Акушерство и гинекология: научно-практический журнал. 2003. № 3. С. 60-6J

31. Коноплянников А. Г. Основная операция в акушерстве: Безопасный выход? Трагедия? Москва. 20J5. www.arfpoint. ru/wp-content/uploads/20J6/03/ Konoplyannikov_operatsiya_kesarevo-sechenie-anest.pdf


Review

For citations:


Popov A.A., Fyodorov A.A., Loginova E.A.,  ,   Better option for fibroids related infertility: in favor of surgery. Medical alphabet. 2017;3(23):46-49. (In Russ.)

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