08 ian. 2019 SURGICALTREATMENT (MYOMECTOMY) VERSUS MEDICAL TREATMENT FOR SYMTOMATIC LEIOMYOMA IN INFERTILE PATIENTS
D. Axente 1, I.G. Goidescu 2, Georgiana Nemeti2, R. Micu 2, Alexandra Itu 2, Alina Surcel , M. Surcel2
1 “ V th Surgical Clinic”
2 1st Department of Obstetrics and Gynaecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Abstract
The treatment of uterine fibroids in sterile patients is yet to be clarified. In the present study (retrospective), we aimed to examine the effectiveness of two therapeutic approaches: medical treatment (3,75 mg Agonist GnRh) and surgical treatment (laparoscopic or hysteroscopic myomectomy) from an implantation consequences point of view. There were 64 patients included in the study – 32 patients for medical treatment and 32 patients for surgical treatment (out of which 10 laparoscopic interventions and 22 hysteroscopic interventions). The results confirm a superior effect of the medical treatment on the junction area thickness (3.9 mm vs 4.9 mm p <0.008). As far as the rate of pregnancy is concerned, there is a clear tendency in favour of the surgical treatment (46.8% vs 25%) but without crossing the statistical relevance threshold p-0.1. The surgical treatment appears to be more effective in the implantation procedure compared to the medical treatment.
Rezumat
Tratamentul fibroamelor uterine la pacientele sterile ramane un subiect neclarificat. In studiul prezent (retrospectiv) ne-am propus sa examinam eficienta a doua abordari terapeutice : tratament medical (Agonist GnRh 3,75 mg – 3luni) respectiv tratament chirurgical (miomectomie laparoscopica sau histeroscopica) prin prisma consecintelor asupra implantarii. Au fost incluse in studiu 64 de paciente – 32 de paciente pentru tratamentul medical, respectiv 32 de paciente pentru tratamentul chirurgical – 10 interventii laparoscopice, 22 interventii histeroscopice) . Rezultatele obtinute confirma un efect superior al tratamentului medical asupra grosimii zonei de jonctiune (3,9 mm vs 4,9 mm p < 0,008 ). In privinta ratei de sarcini exista o tendinta clara in favoarea tratamentului chirurgical (46,8 % vs 25%), fara a se atinge insa pragul de relevanta statistica p-0,1 Tratamentul chirurgical pare a fi mai eficient in privinta fenomenului implantarii comparativ cu tratamentul medical.
Cuvinte cheie: miomectomie, infertilitate, tratament
Citeste tot articolul in format pdf