Efficacy of hormonal therapies for decreasing uterine volume in patients with adenomyosis

Takashi Matsushima; T Matsushima; Shigeo Akira; Takehiko Fukami; Koichi Yoneyama; Toshiyuki Takeshita

doi:10.4103/gmit.gmit_35_18

Efficacy of hormonal therapies for decreasing uterine volume in patients with adenomyosis

Takashi Matsushima, T Matsushima, Shigeo Akira, Takehiko Fukami, Koichi Yoneyama, Toshiyuki Takeshita

Gynecology and minimally invasive therapy · 2018 · vol. 7(3) , pp. 119 · doi:10.4103/gmit.gmit_35_18 · PMID:30254953 · PMC6135169 · W2888669310

article OA: gold CC0 ⤵ 32 in-corpus citations

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Abstract

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.

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