Submucosal leiomyoma of the uterus in combination with adenomyosis. Principles of target therapy in the reproductive period

Gynecology, Obstetrics and Perinatology - Gynecology, Obstetrics and Perinatology - 2019 volume 18 issue 3 Submucosal leiomyoma of the uterus in combination with adenomyosis. Principles of target therapy in the reproductive period Authors / Institutions Aleksandr I. Davydov / Vladimir M. Pashkov / Marina N. Shakhlamova / The authors present a tactics of treating patients with submucosal leiomyoma of the uterus (SLM) in combination with adenomyosis, which is grounded on operative hysteroscopy (transcervical myomectomy, excision of adenomyotic foci) and hormonal therapy – pre-operative preparation with ulipristal acetate (UPA) 5 mg/day and Siluet (ethinylestradiol + dienogest). As is shown, in SLM types 1–2 UPA ensures not only reduction of the volume of submucosal uterine tumour (on average by 36%), but also its conversion to types 0–1, and also fast hemostasis under the conditions of severe iron deficiency. Siluet is notable for its high effectiveness with respect to prevention of the growth of adenomyosis and inactivation of unremoved heterotopias in combination with adequate compliance. Key words: adenomyosis, operative hysterectomy, ulipristal, submucosal leiomyoma, target therapy, ethinylestradiol + dienogest. For citation: Davydov A.I., Pashkov V.M., Shakhlamova M.N. Submucosal leiomyoma of the uterus in combination with adenomyosis. Principles of target therapy in the reproductive period. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(3): 124–132. (In Russian). DOI: 10.20953/1726-1678-2019-3-124-132 by 36%), but also its conversion to types 0–1, and also fast hemostasis under the conditions of severe iron deficiency. Siluet is notable for its high effectiveness with respect to prevention of the growth of adenomyosis and inactivation of unremoved heterotopias in combination with adequate compliance. Key words: adenomyosis, operative hysterectomy, ulipristal, submucosal leiomyoma, target therapy, ethinylestradiol + dienogest. For citation: Davydov A.I., Pashkov V.M., Shakhlamova M.N. Submucosal leiomyoma of the uterus in combination with adenomyosis. Principles of target therapy in the reproductive period. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(3): 124–132. (In Russian). DOI: 10.20953/1726-1678-2019-3-124-132