Oral Presentation

What can be expected from Ulipristal in the treatment of uterine fibroids?

Aleksandar Jurisic (RS), Zaklina Jurisic (RS), Dejan Dinic (RS), Svetlana Dragojevic Dikic (RS), Sladjana Mihajlovic (RS)

[Jurisic] University of Belgrade Medical School, Narodni Front University Hospital, Beograd, [Jurisic] OB/GYN Polyclinic "Jurisic", Beograd, [Dinic] KBC Zemun, Beograd, [Dragojevic Dikic] University of Belgrade Medical School, Narodni Front University Hospital, Beograd, [Mihajlovic] University of Belgrade Medical School, Narodni Front University Hospital, Beograd

Objective: To evaluate 3-month Ulipristal administration in the treatment of uterine fibroids and its potential role in reduction of surgical procedures in patients with diagnosed uterine fibroids. Methods: In this prospective study 45 patients with uterine fibroids were included. The indication for treatment with was reduction of tumour volume, reduction of uterine bleeding, and preparation for IVF procedure. In this study tumour volume and vascularization of uterine fibroid were analyzed before and after treatment with 5 mg Ulipristal tablets for three months. Total uterine volume and resistance indices in the uterine arteries were also analyzed before and after medicamentous treatment. Statistical analysis was performed in order to compare parameters before and after treatment with Ulipristal. Results: Mean patient’s age in our study group was 41,4±5,5 years. The total of 80 fibroids were analyzed in our study. Mean fibroid volume before treatment was 94,94±42,92 ml. Significant reduction of fibroid volume was observed after treatment (71,92±32,24ml). Mean uterine volume before treatment was 266,20±82,07 ml. Significant reduction of uterine volume was observed after treatment (232,16±73,33ml). Reduction of fibroid volume and also of uterine volume was achieved in 40 patients. In 5 patients, after initial treatment with 5mg Ulipristal for 3 months, reduction of fibroid and uterine volume was not observed. Fibroid vascular resistance indices did not significantly change after therapy (RI=0.612±0.048 and 0.659±0.051). Uterine artery vascular resistance was not changed after therapy (RIAUD=0.802±0.036 and 0.802±0.029. RIAUS=0.799±0.04 and 0.812±0.035 successively). Reduction of uterine bleeding was present in all patients during therapy and also after finished therapy. Conclusion: Five mg of Ulipristal therapy in three month period, has good potential as primary treatment in patients with uterine fibroids , especially in older patients who should be included into IVF procedure, and also patients who need preoperative correction of anaemia and also reduction of tumour volume before operative procedure.

 

 

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