Significant Reduction In Uterine Volume Research Articles

Clinical efficacy of myometrial and endometrial microwave ablation in the treatment of patients with adenomyosis who had anemia

Objective This study evaluated the clinical efficacy of myometrial and endometrial microwave ablation (MEWA) for treating adenomyosis in patients with anemia. Methods This retrospective study enrolled 64 patients with adenomyosis who had anemia treated with either MEWA (MEWA group) or myometrial microwave ablation (MMWA group) between May 2019 and May 2021. The uterine volumes, uterine-volume reduction rates, hemoglobin (Hb) levels, cancer antigen 125 (CA125) levels, dysmenorrhea visual analog scale (VAS) scores, uterine fibroblast symptoms and health-related quality of life (UFS-QOL) scores, menstrual flow scores (MFS) before and 3, 6, and 12 months post-treatment, and adverse events and complications in both groups were collected to assess clinical efficacy. Results No statistically significant preoperative differences were observed in any measured factors. Postoperatively, there was a significant reduction in uterine volume and CA125 level, an increase in Hb level, and improvement in the UFS-QOL, dysmenorrhea VAS score, and MFS. No differences were observed in postoperative uterine volume, CA125 level, overall response rate, and adverse event rate during the follow-up period until 12 months postoperatively. However, the MEWA group showed a better uterine-volume reduction rate 6 months postoperatively and improvement in Hb level, USF-QOL score, dysmenorrhea VAS score, and MFS postoperatively. Conclusion MEWA and MMWA demonstrated high clinical efficacy in treating adenomyosis and anemia. However, MEWA is a more effective therapy that successfully improves anemia, resulting in improved quality of life.

Treatment of Endometriosis and Leiomyoma with the Association of Miodesin and Gestrinone in Pentravan Through the Vaginal Route

Introduction: The effects of Myodesin™ (Fagron, Brazil) on uterine volume and pain scores were investigated in a group of patients with leiomyoma and endometriosis. Myodesin™ was used either alone or in combination with vaginal gastronone. Patient and Methods: Forty two patients with uterine leiomyoma and endometriosis were enrolled for this study and divided into 3 groups according to the treatment scheme. In Group A (n=16) they were treated with a higher dose of vaginal Gastronome alone (5mg twice a week). In Group B (n=16) patients received a lower dose of Gestrinone (2.5 mg twice a week) together with vaginal Miodesin™ (500 mg/dose daily) (Fagron Brazil). In Group C (n=10) patients were treated only with Miodesin™. All medications were dispensed vaginally dissolved in Pentravan™ (Fagron, Netherland). Results: The average uterine sizes before treatment were 200 cm3, 334 cm3, 242cm3 in group A, B and C respectively and they were not statistically different. After the second month a significant reduction in uterine volume was observed in all treated groups. However the reduction in uterine volume was greater in group than in group C. The proliferation rates in both stroma and endometrial gland measured by Ki-67 were low with a mean value of 2% with no significant differences between groups A and B. Treatment with Gestrinone decreased significantly total pain scores (VAS) when used either alone or in combination with Myodesin™. However this decrease was significantly greater in Group B than in Group A.Treatment with Miodesin alone (Group C) also decreased significantly pain scores. Conclusion: Miodesin treatment increased the efficacy of Gestrinone to reduce pelvic pain and uterine volume in patients with endometriosis and leiomyoma.

Efficacy of Hormonal Therapies for Decreasing Uterine Volume in Patients with Adenomyosis.

Study objective:The aim of this study is to evaluate the efficacy of hormonal therapies for inhibiting an increase in uterine volume in patients with adenomyosis.Design:This was retrospective cohort study.Setting:This study was conducted at Nippon Medical School Musashikosugi Hospital.Patients:A total of 28 women diagnosed with adenomyosis using magnetic resonance imaging.Methods:After providing informed consent, patients were treated with gonadotropin-releasing hormone agonist (GnRHa group), a low-dose estrogen and progestin combination (LEP group), or dienogest (DNG group) for ≥16 weeks. Uterine volume was assessed using the formula for an ovoid; uterine volumes before and after 16 weeks of treatment were compared. A <5% increase in uterine volume at 16 weeks was considered to reflect inhibition of uterine volume increase and efficacy of the medication. We compared the efficacy rate among the groups.Results:In the GnRHa group, a significant reduction in uterine volume was noted, from 307.4 ± 230.1 to 177.9 ± 142.1 cm3 (P < 0.001). In the LEP and the DNG groups, there was no significant change (LEP: 226.7 ± 116.6 cm3 pre-treatment and 230.5 ± 128.6 cm3 post-treatment, P = 0.85; DNG: 232.6 ± 117.8 cm3 pre-treatment and 262.1 ± 136.8 cm3 post-treatment, P = 0.37). The number of responders (efficacy rate) in the GnRHa group, LEP group, and DNG group was 25/26 (96.2%), 7/15 (46.7%), and 6/11 (54.5%), respectively. The efficacy rate of GnRHa therapy was significantly higher than that of LEP or DNG therapy (P < 0.001 and P = 0.005, respectively).Conclusion:We conclude that the efficacy of GnRHa in reducing uterine volume should be considered when prescribing hormone therapy for adenomyosis.

Efficacy of a low-dose leuprolide acetate depot in the treatment of uterine leiomyomata in Japanese women

To compare the efficacy of two different doses, 1.88 mg and 3.75 mg, of a monthly depot injection of a gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of uterine leiomyomata. A prospective randomized study. Hospital department of gynecology and obstetrics. Forty-one premenopausal Japanese women, 25 to 53 years of age, with uterine leiomyomata. Depot type of GnRH-a, leuprolide acetate (LA) 1.88 mg or 3.75 mg was administered subcutaneously every 4 weeks for 24 weeks. Efficacy of treatment was assessed in terms of uterine volume, serum levels of estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and adverse symptoms during treatment. In both groups, a significant reduction in uterine volume, 52% in 1.88 mg group and 47% in 3.75 mg group, was obtained at week 24, with near maximal reduction (41%, 45%) apparent by 12 weeks. No significant difference was observed between the groups in percent uterine volume reduction at each treatment week. Both groups showed significant and equal suppression of serum levels of E2, LH, and FSH. In addition, the incidence of adverse symptoms was not significantly different between the two groups. Monthly injection of 1.88 mg or 3.75 mg LA depot has equivalent treatment efficacy in reducing uterine volume. Twelve weeks of treatment is enough to obtain near maximal reduction.

Treatment of uterine leiomyomata with a luteinizing hormonereleasing hormone agonist: the possibility of nonsurgical management in selected perimenopausal women

To evaluate the efficacy of luteinizing hormone-releasing hormone agonist (LH-RH-a) in the treatment of leiomyomata. A retrospective randomized trial. Hospital department of obstetrics and gynecology. Twenty-five women, ages 36 to 54 years with symptomatic uterine leiomyomata, were divided into two groups according to the responsiveness to LH-RH-a: group A patients reached menopause after LH-RH-a, whereas resumption of menstruation occurred within 12 weeks after cessation of therapy in group B. Luteinizing hormone-releasing hormone agonist was administered intranasally three times a day with 150 micrograms insufflation of one spray in each nostril (total dose: 900 micrograms/d). Efficacies of treatment were assessed in terms of uterine volume, hemoglobin concentrations, serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), and bone density during and after treatment. In both groups, hemoglobin concentrations increased significantly after 16 weeks of treatment. A significant reduction in uterine volume was observed in both groups. After completing therapy, there was no further significant change in uterine volume in group A, whereas uterine volume in group B returned to pretreatment values. Serum LH and FSH concentrations were suppressed during treatment, but those gonadotropins in group A increased significantly up to the menopausal levels after treatment. Serum E2 concentrations in both groups showed consistent suppression by the end of the first treatment cycle. After cessation of therapy, serum E2 levels on group A remained in the castrate range, whereas E2 in group B returned to pretreatment levels, concomitant with the return of normal ovulation. Intranasal administration of LH-RH-a was successful in significantly decreasing uterine volume and increasing hemoglobin concentration in premenopausal women with leiomyomata.

Treatment of leiomyomata with intranasal or subcutaneous leuprolide, a gonadotropin-releasing hormone agonist

Fourteen premenopausal women with uterine leiomyomata were randomized to receive a gonadotropin-releasing hormone agonist (GnRH-a), leuprolide, either by daily subcutaneous (SC) injection (500 µg/day) or by intranasal (IN) spray (1600 µg/day) for 24 weeks. In the SC group, a significant reduction in uterine volume occurred from a pretreatment volume of 368 ± 60 (mean ± standard error of the mean [SEM]) cm3 to 202 ± 61 cm3 at 12 weeks of therapy (P < 0.01) and to 172 ± 49 cm3 at 24 weeks of therapy (P < 0.005). In the IN group, no significant reduction in uterine volume occurred. In addition, there was a significant negative correlation between the serum estradiol concentration during treatment and the percent decrease in uterine volume (r = −0.55, P < 0.05). Four months after completing therapy, uterine volume increased to 296 ± 104 cm3 in the SC group, which was not significantly different from pretreatment volume. These findings suggest that reduction in uterine volume depends on the degree of hypoestrogenism induced and that uterine volume increases soon after cessation of GnRH-a therapy.