Poster Session

P76. Prevention of the recurrence of uterine fibroids after myomectomy

Alexander Tikhomirov (RU)

[Tikhomirov] Moscow State Medico-stomatological university

Context. In Russia to 45 years each 4 woman is in a state of postgisterektomy, which is most often done about uterine fibroids. Most of these women, despite this age performed reproductive function, do not want to part with the uterus, associating this organ with femininity and sexuality. Due to the lack of true malignisation awareness myoma, conservative operations can be conducted (myomectomy). However. recurrences of uterine fibroids after myomectomy registered up to 45% of cases. Tasks. Prevent relapses of myoma after myomectomy. Methods. General clinical, ultrasound, surgical, morphological. Patients. 50 patients with uterine myoma (average age of 45.5 years) with the completed reproductive function and the desire to preserve the uterus. Interference. Myomectomy - ulipristal acetate 3 month - levonorgestrel releasing intrauterine system before menopause. Main indicators. Morphologically setting 2013 year absence the beginnings of growth of uterine fibroids in the surrounding isn't altered myometrium after a three-month use of ulipristal acetate by 5 mg a day for 84 days as a preoperative preparation to myommyometrectomy, from 2014 onwards began to use it as a tragedy of the first phase of the complex treatment of uterine fibroids relaps. The next rational step was elected to use intrauterine hormonal system Mirena. The results. The absence of recurrence of uterine fibroids and endometrial hyperplasia all observed patients, amenorrhea after two years of observation with subsequent expected transition in postmenopause at 88.8% of patients, normalization of hematological indicators and stable quality of life 100%. Conclusions. A significant advantage of ulipristal acetate in the early postoperative period after myomectomy is the lack of side effects from hormonal ablation that previously experienced in the application of aGnRG after myomectomy to suppress possible microscopic germs growth of uterine fibroids. The second phase of antirecurrence therapy of myoma after myomectomy using intrauterine hormonal system "Mirena" not only reduces the period of hormonal suppression in these patients and provides reliable contraception, but also prevents blood loss, as well as prevention of occurrence of hyperplastic endometrial processes, thereby ensuring a high quality of life and the prevention of repeat surgical procedures.