Impact of uterine artery embolization on ovarian function and pregnancy outcome after uterine-fibroids treatment:A prospective study

Uterine fibroids are benign tumors that originate from smooth muscle cells of the uterus.It is the most common gynecological disorder,affecting up to 80%of women of reproductive age.Uterine fibroids can cause various symptoms such as abnormal uterine bleeding,pelvic pain,infertility,and pregnancy complications.The treatment options for uterine fibroids include medical therapy,surgical intervention,and minimally invasive techniques.AIM To compare ovarian function of women with uterine fibroids who did or did not undergo uterine artery embolization(UAE).METHODS This prospective cohort study enrolled 87 women with symptomatic uterine fibroids who underwent UAE,and 87 women with the same symptoms who did not undergo UAE but received conservative management or other treatments.The two groups were matched for age,body mass index,parity,and baseline characteristics of uterine fibroids.The primary outcome was ovarian function that was evaluated by serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH),as well as ovarian reserve tests,such as antral follicle count(AFC)and ovarian volume(OV).The secondary outcome was fertility that was evaluated based on the menstrual cycle,ovulation,conception,pregnancy,and delivery.The participants were followed-up for 36 months and assessed at 1,3,6,12,24,and 36 months after treatment.RESULTS The study found that the most common minor complication of UAE was postembolization syndrome in 73.6% of women,resolving within a week.No significant differences were observed between the UAE group and the control group in serum levels of reproductive hormones(FSH,LH,E2,AMH)and ovarian reserve indicators(AFC,OV)at any point up to 36 months post-treatment.Additionally,there were no significant differences in conception,pregnancy,or delivery rates,with the average time to conception and gestational age at delivery being similar between the two groups.Birth weights were also comparable.Finally,there was no significant correlation between ovarian function,fertility indicators,and the type or amount of embolic agent used or the change in fibroids posttreatment.CONCLUSION UAE resulted in significantly positive pregnancy outcomes,no adverse events post-treatment,and is a safe and effective treatment for uterine fibroids that preserves ovarian function and fertility.

Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids

BACKGROUND Currently,the use of dienogest in clinical practice has increased significantly,and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis;however,the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.AIM To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.METHODS The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.RESULTS The maximum uterine fibroid diameter and volume increased after 3 months,6 months and 1 year of dienogest treatment compared with those before treatment(P<0.01).The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment,but the difference was not significant(P>0.05).Endometrial thickness and antigen 125 levels were significantly thinner and decreased,respectively,after dienogest treatment(P<0.01).Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume(r=0.792,P<0.01).Among 64 patients with dysmenorrhea,63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest,and all patients experienced significant relief of dysmenorrhea after 12 months.Patients were able to tolerate the drugs,with an average drug tolerance score of 8.73.CONCLUSION The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts,but it cannot inhibit uterine fibroid growth.

Clinical and Demographic Profile of Women with Uterine Fibroids Living in Puerto Rico

Introduction: Uterine leiomyomas, or fibroids, are prevalent benign tumors affecting up to 70% of reproductive-age women in the United States, significantly impacting productivity and quality of life. Despite their commonality, the epidemiology and clinical patterns of leiomyomas in Puerto Rico remain inadequately researched. Methods: This study conducted a secondary data analysis using clinical, menstrual cycle characteristics, and demographic data from self-administered questionnaires of women undergoing diagnostic laparoscopy for endometriosis in Puerto Rico. Chi-square tests and t-tests analyzed categorical and continuous variables, respectively (p Results: Among 1,610 endometriosis cases, 312 included uterine fibroids. Prevalence estimates were 10.3% (40 years). Primiparous women averaged 22.14 years, with 40.71% having 2 - 3 pregnancies and 26.28% experiencing miscarriages. Symptoms included infertility (29.5%), dyspareunia (40.7%), severe pain (50%), and dysmenorrhea (75.6%). Comorbidities included ovarian cysts (52.2%) and abnormal uterine bleeding (37.8%). Conclusions: Advanced age, parity, and comorbidities like diabetes and hypertension were prevalent in our cohort. Understanding the epidemiological profile of women living in Puerto Rico with uterine fibroids is crucial for improving diagnostic awareness and enhancing patient care.

Evaluation of the Efficacy and Effectiveness of Hysteroscopic Electroresection in the Treatment of Submucosal Uterine Fibroids

Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.

Associated Factors and Consequences of Uterine Fibroids in Hospitals in the Borgou Department of Benin in 2022

Introduction: Uterine fibroids are the most common gynecological tumors in women of childbearing age and have multiple clinical manifestations. Objective: To determine factors associated with uterine fibroids in the Borgou department of Benin in 2022. Method: Descriptive, analytical cross-sectional study from August 22 to September 22, 2022. The sample consisted of women consulting for gynecological problems in 6 hospitals in the Borgou department in the North of Benin. Results: Of the 744 women surveyed, 10.1% were diagnosed with uterine fibroids. Women with uterine fibroids were often married, paucigesture, and nulliparous. Their main reasons for consultation were the desire for motherhood (50.7%), pelvic pain (46.7%), and genital hemorrhage (14.7%). Age, history of miscarriage, high blood pressure, and diabetes were significantly associated with the presence of uterine fibroids (Conclusion: Uterine fibroids are common in hospitals in northern Benin. There were factors associated with them that should be taken into account in management strategies.

Discussion on the Application of Operating Room Nursing in Patients with Uterine Fibroids and Diabetes

Objective: To analyze the application value of surgical nursing in patients with uterine fibroids and diabetes. Method: Sixty diabetic patients who agreed to undergo surgery for uterine fibroids at the Sun Yat-sen University Cancer Center from January 2021 to May 2022 were randomly selected as the study subjects. According to criteria such as number of patients, age, nursing methods, and treatment methods, the patients were evenly divided into an observation group and a control group. The control group received routine nursing measures, while the observation group received focused surgical nursing measures based on the routine ones. The blood glucose and blood lipid metabolism status, the incidence of adverse reactions, and nursing satisfaction were compared between the two groups. Results: The blood glucose and blood lipid metabolism status of the observation group were safer than those of the control group (P < 0.05). The observation group had advantages in terms of the incidence of adverse reactions and nursing satisfaction compared to the control group (P Conclusion: Systematic surgical nursing for patients with uterine fibroids and diabetes during surgery can help patients control their blood glucose and blood lipid metabolism status, reduce the incidence of adverse reactions, and improve the patient’s experience during the treatment stage.

Surgical Management of Uterine Fibroids: About 175 Cases

Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management of patients with uterine fibroids. Patients and Method: We carried out a retrospective and descriptive study carried out over a period of 30 months, from August 1, 2017 to January 31, 2020, concerning all patients who underwent surgery for the treatment of uterine myomatosis in the department of Gynecology Obstetrics of the Hospital Principal of Dakar. The data was collected from the patients’ medical records and analyzed using Excel version 2016 and R version 4 software. Results: We collected 175 surgical interventions for uterine fibroids, representing 44.7% of gynecological interventions. Most of the patients were between 30 and 39 years old, with an average age of 39 years. The nulliparous were the majority with 64.6%. The clinical symptomatology was represented by genital bleeding (32.6%), pelvic pain (18.85%) and infertility (12.6%). The diagnosis was confirmed by pelvic ultrasound in all patients with variable myoma topography. A myomectomy was performed in 82.3% of cases and a total hysterectomy in 17.7%. The postoperative course was simple in 94.2% of cases, and the results of treatment revealed a disappearance of symptoms in 94.3% of cases. Conclusion: Surgery occupies a prominent place in the management of uterine fibroids.

The clinical study of ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute combined with HIFU in the treatment of uterine fibroids

Objective The aim of this study was to investigate the energy deposition in the target area of high intensity focused ultrasound （HIFU） with ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute Methods Eighty patients with hysteromyomas were randomly divided into two groups： group HIFU （group H） and group HIFU combined with ullrasound-guided inlra-hysteromyoma injectionn of ethyl alcohol absolute （group E ＋ H）. Patients in group E ＋ H received an ullrasound-guided injection of absolute ethyl alcohol 1 h before HIFU treatment. The irradiation time, irradiation dose, energy efficiency factor （radiation energy required for ablation of a myoma per unit of volume）, grey variation, pain score, and adverse reactions were compared between the two groups. An independent sample t-test was used with a two- tailed P-value of 〈 0.05. Results The irradiation time, irradiation dose, and energy efficiency factor were significantly lower in group E ＋ H than those in group H （P 〈 0.05）. The hysteromyomas of patients in group E＋H appeared as dominantly hyperechoic masses, and those of patients in group H appeared as hyperechoic tissue （non- mass）. The incidence of adverse reactions and pain score were higher in group H than those in group E ＋ H （P 〈 0.05）. Conclusion Ultrasound-guided inlra-hysteromyoma injection of ethyl alcohol absolute can enhance the energy deposition of HIFU in the uterine fibroids, improve the treatment efficiency, shorten the treatment time, reduce the treatment dose, and reduce the pain and complications for the patients.

Ventral hernia after high-intensity focused ultrasound ablation for uterine fibroids treatment:A case report

BACKGROUND High-intensity focused ultrasound(HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids.Although this procedure is safe and effective,adverse outcomes are becoming a major problem.CASE SUMMARY We present a case of ventral hernia that occurred as a rare and delayed complication of HIFU ablation for uterine fibroids treatment.The patient came to the hospital with abdominal bloating that occurred 6 mo after ultrasound-guided HIFU ablation for managing uterine fibroids.The ventral hernia,which occurred due to atrophied muscle layers following the procedure,was confirmed by imaging studies and intraoperative findings.She required a hernia repair with mesh and hysterectomy for definitive treatment of uterine fibroid.CONCLUSION High-intensity ultrasound ablation should be performed only on appropriate candidates.Patients should be educated about potential complications of the procedure and the possibility of subsequent treatment.Post-procedural long-term follow-up for detecting delayed adverse effects is important.

Effect of selective uterine artery embolization on symptomatic uterine fibroids

Objective： To evaluate the outcomes of selective uterine artery embolization （SUAE） in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography （CDUS）. Methods： As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results： SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [（322± 12） cm^3] and uterine fibroids [（125±46） cm^3], their volumes in post-SUAE were （144±72） cm^3 and （51 a：l 1） cm^3 （P〈0.01）, and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE （P〉0.05）. After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved （P〈0.01）. 90.8% （59/65） women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% （34/40） complications were minor, requiring no therapy. 9.2% （6/65） had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion： SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women＇s health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.

Percutaneous Ultrasound-Guided Radiofrequency Thermal Ablation for Treatment of Uterine Fibroids

Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic uterine fibroids despite conventional medical treatment were included. The assessment of symptoms and characteristics of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) was performed before starting treatment and 6 months after the procedure. Successful treatment was clinically considered if patients reported a reduction in symptoms 6 months after RF myolysis. Successful treatment was also considered if the necrosis of the fibroid was greater than 50%, 6 months after treatment. Results: The baseline score on visual analogue scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ± 3.4, respectively. According to a score of 0 - 3, baseline bleeding during menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p = 0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17 patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI monitoring 6 months post-myolysis. Compared to baseline fibroid volume, ultrasound and MRI volume were 57.38% and 79.66% six months after surgery, respectively. A total of 13 patients (92.86%) had radiological success from the treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis reduces volume and symptoms of uterine fibroids, it may be considered as a valid treatment for symptomatic fibroids.

A Five-Year Survey of Uterine Fibroids at a Nigerian Tertiary Hospital

Introduction: Uterine leiomyomas, commonly called fibroids are benign tumors of uterine myometrium composing of smooth muscle with variable amount of connective tissue and common gynecological problem among women of reproductive age. It is the commonest tumor of the female pelvic organ. Objective: To determine the incidence of uterine fibroids, socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Material and Methods: This is a retrospective descriptive analysis of all the uterine fibroids carried out at the University of Abuja Teaching Hospital, Gwagwalada from 4th January 2013 to 31st December 2017. Data were obtained from medical records, gynaecological ward and theatre records of University of Abuja Teaching Hospital. Data were analyzed using socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Results were presented using simple percentages and ratios. Results: Uterine fibroids accounted for 6.4% of all gynaecological admissions and 21. 3% of all major gynaecological surgeries. Uterine fibroid was found to be common between the age range 30 - 39 (47.5%) years, followed by 20 - 29 (26.3%) and 40 - 49 (15.7%) years. One hundred and twenty-two (61.7%) were nulliparous while 48 (24.2%) were primiparous. Majority of the women 88 (44.4%) had tertiary education, 49 (24.7%) secondary, 48 (24.3%) primary and 13 (6.6%) had no formal education. Seventy-six (38.4%) presented with menorrhagia, abdominal mass 71 (35.9%), infertility 68 (34.3%) and abdominal pain 48 (24.2%). Most of the patients had multiple fibroids, 81 (40.9%) had intramural, 70 (35.4%) submucous and 52 (26.3%) subserous. Out of 198, 165 (83.3%) had myomectomy, 23 (11.6%) had total abdominal hysterectomy and 9 (4.6%) myomectomy and tuboplasty. Anaemia 41 (20.7%) was the commonest morbidity, followed by wound infection 12 (6.1%) and wound dehiscence 4 (2.0%). No mortality was recorded during the period under review. Conclusion: Uterine fibroid is common in our environment and usually presents with menorrhagia, abdominal mass, infertility, pelvic pain, and recurrent miscarriage. Thus healthy lifestyle should be encouraged and routine checkups conducted so as to detect and possibly treat such tumours early.

Anesthetic effect of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids

Objective: To study the effect of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids on pain degree, pain mediator and stress mediator secretion as well as stress signal molecule expression. Methods: 78 patients with uterine fibroids who received high intensity focused ultrasound treatment in Shaanxi Second Provincial People's Hospital between February 2015 and February 2018 were selected as the research subjects and randomly divided into the Dex group who accepted dexmedetomidine + fentanyl + midazolam anesthesia and the control group who accepted fentanyl + midazolam anesthesia. The pain degree was assessed 1 day and 3 d after surgery;the secretion of pain mediators and stress mediators in serum as well as the expression levels of stress signaling molecules in peripheral blood were measured before surgery and 3 d after surgery. Results: 1 d and 3 d after surgery, the NRS pain scores of Dex group were significantly lower than those of control group;3 d after surgery, serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of both groups of patients were higher than those before surgery whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were lower than those before surgery, and serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of Dex group 3 d after surgery were lower than those of control group whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were higher than those of control group. Conclusion: The application of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids can reduce the degree of postoperative pain and stress response.

Effect of Guizhi Fuling Capsule on sex hormone level and tumor markers in patients with uterine fibroids

Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroids who were treated in our hospital from August 2016 to August 2017 were selected according to the order of treatment and divided into observation group and control group, 60 cases each. Mifepristone was administered to the control group and mifepristone combined with Guizhi Fuling Capsules was administered to the observation group. The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups.Result:The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups. After treatment, hemoglobin levels increased significantly in the two groups, VEGF, sex hormones FSH, LH and E2, tumor markers HE4, CA125, inflammatory cytokines TNF-α and IFN-γ levels decreased significantly. The hemoglobin level of the observation group was (117.09±11.51) g/L higher than that of the control group , and the level of VEGF was (0.69±0.06) pg/mL lower than that of the control group. The levels of sex hormone FSH, LH and E2 in the observation group were (15.87±1.56) U/L, (10.69±1.06) U/L and (4.95±0.51) pmol/L lower than those of the control group. The levels of HE4, CA125, TNF-α and IFN-γ gamma in the observation group were (52.47±5.24) pmol/L, (15.46±1.53) U/mL, (40.41±4.05) and (16.72±1.62) pg/mL lower than those of the control group.Conclusion:Guizhi Fuling Capsule can significantly improve the level of sex hormones and tumor markers, relieve inflammatory stress and improve the therapeutic effect.

Effect of Gongliuxiao Capsule on sex hormones, tumor markers, inflammatory factors and vascular endothelial function in patients with uterine fibroids

Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine fibroids admitted to our hospital from October 2015 to March 2017 were enrolled. According to the treatment, they were divided into single treatment group and combined medication group, with 65 cases in each group. The changes of inflammatory factors, tumor markers, sex hormones and vascular endothelial function were compared before and after treatment in the two groups.Results: There were no significant differences in the levels of sex hormones, inflammatory factors, tumor markers and vascular endothelial function between the two groups (P>0.05). The levels of sex hormones E2, P, FSH and LH, the levels of inflammatory factors TNF-α, MMP-9 and IGF-1, tumor markers CA125, CA19-9 and vascular endothelial function VEGF and b-FGF were significantly lower in the two groups (P<0.05). The levels of E2, P, FSH and LH in the combined drug groupswere (154.12±16.20) pmol/L, (9.12±1.02) μg/L, (13.84±1.42) U/L and (12.77±1.36) U/L, respectively,which were significantly lower than the single drug group level (P<0.05). The levels of CA125 and CA19-9 in the combined drug group were (27.89±2.88) U/mL and (28.09±3.04) U/mL, respectively, which were significantly lower than the single drug group (P<0.05). The levels of TNF-α, MMP-9 and IGF-1 in the combined drug group were (24.16±2.63) ng/L, (159.22±16.82) μg/L and (69.75±7.09) μg/L, respectively, which were significantly lower than the single drug group(P<0.05). The levels of VEGF and b-FGF in the combination group were (138.29±14.32) μg/L and (98.59±10.02) μg/L, respectively, which were significantly lower than the single drug group (P<0.05).Conclusion:Mifepristone combined with Gongliuxiao Capsule can alleviate endocrine disorders, relieve inflammatory stress response and improve vascular endothelial function in patients with uterine fibroids. It is worthy of clinical application.

Efficacy of Carboprost Tromethamine Combined with Mifepristone in the Treatment of Uterine Fibroids

The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects.According to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 people.The oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group.The treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor levels.The clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant difference.Finally,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control group.The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further comparison.Carboprost tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.

Research Progress of TCM Treatment of Uterine Fibroids

Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.

Effect of Modified and accumulated decoction on serum ER, PR, sex hormone, IGF-I and IGF-I in patients with uterine fibroids

Objective: To study the effect of Modified and accumulated Decoction on serum ER, PR, sex hormone, IGF-I and IGF-I in patients with uterine fibroids. Method: A total of 90 patients with uterine fibroids in our hospital from January 2015 to January 2017 were enrolled in this study. The subjects were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group was treated with mifepristone, the treatment group was treated with Modified and accumulated Decoction combined with mifepristone, and both the two groups were treated for 3 months. The uterine fibroid volume and uterine volume of the two groups before and after treatment were compared. The serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups before and after treatment were compared. Result: There were no significantly differences of the uterine fibroid volume and uterine volume of the two groups before treatment. The uterine fibroid volume and uterine volume of the two groups after treatment were significantly less than before treatment, and that of the treatment group after treatment were significantly less than the control group. There were no significantly differences among the serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups before treatment. The serum ER, PR, P, E2, LH, FSH, IGF-I and IGF-IR of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly lower than the control group. Conclusion: Modified and accumulated Decoction combined with mifepristonecan significantly reduce the uterine fibroid volume, improve the serum ER, PR, sex hormone, IGF-I and IGF-I levels of the patients with uterine fibroids, and it was worthy clinical application.

The Comparison Between Two Kinds of Integrative Medicine Therapy with the Single Mifepristone in the Treatment of Uterine Fibroids

Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.

Ulipristal Acetate (UPA): An Alternative Option to Surgery for Uterine Fibroids in Reproductive Age: A Review

Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.