Gromova A.M., Nesterenko L.A., Tarasenko K.V., Martynenko V.B.

CLINICAL EFFICACY OF SELECTIVE PROGESTERONE RECEPTOR MODULATORS IN THE TREATMENT OF BENIGN TUMORS OF UTERUS FOR WOMEN IN REPRODUCTIVE AGE

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About the author:	Gromova A.M., Nesterenko L.A., Tarasenko K.V., Martynenko V.B.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	Myoma of uterus is one of the actual problems of gynecology and occurs in 30-35% of women of reproductive age, and in the age of 45 occurs 40%. This pathology is often manifested by abnormal uterine bleeding and is one of the reasons histerectomy [2, 4]. The Appearance of a new drug from the group of selective progesterone receptor modulators (SPRM) allowed an effective medical treatment in a group of women of fertile age with conservation of reproductive function. Significant and evident regression of myoma nodes without the surgical intervention in part of patients or provide myomectony with preserving reproductive function [3, 10]. Aim of the study was to determine the efficacy of selective progesterone receptor modulators for women in reproductive age with uterine leiomyoma compared to agonistgonadotropine-releasing hormone (aGn-RH). Materials and methods The clinical study was conducted in 19 non-pregnant women of reproductive age (25-40 years) with the presence of uterine fibroids large size (diameter dominant myoma node ranged from 5 to 12 cm). Depending on the method of treatment, all patients were divided into two groups: the first group consisted of 8 women treated with selective progesterone receptor modulators; the second group - 11 patients who toked a course of therapy agonist-gonadotropin-releasing hormone. Sizes of uterus of examined patients before surgery were in the group I - 326,4 ± 158,2 cm3, in Group II - 337,6 ± 169,5 cm3 (r≥0,05). The volume of tumer in the study group was increased by the presence of various nature and localization leyomyoma nodes. In 6 (31.6%) women surveyed marked subserous location of nodes in 3 (15.8%) -intramurale and 10 (52.6%) - mixed. In the study of resistance index, during dopplerographie of nodes in the first and second groups were found statistically significant differences, (0,64 ± 0,12 and 0,65 ± 0,11, respectively; r≥0,05). Preoperative therapy in both groupe reduce uterine size by an average of 38.4% . With SMPR using in women and smaller groups noted the severity of side effects that are caused by hypoestrenogemia (unlike agonistHn-RH) - was not severe vasomotor symptoms (hot tides). The overall indicator 'overall quality of life "has been significantly reduced in the first and second groups before treatment (58,2 ± 26,7 and 55,9 ± 29,8, respectively); after treatment was noted improvement in this indicator (68,5 ± 19,3 and 65,8 ± 27,5, respectively); and 3 months after surgery was observed significant improvement "overall quality of life" (I - 89,1 ± 16,8, the second - 77,3 ± 18,3, respectively). Conclusions. 1. Analysis of the results showed the feasibility of preoperative and postoperative periods selective progesterone receptor modulators for 3 months. 2. Appointment of selective progesterone modulators retseptors get better qualityoflife. 3. When using selective progesterone receptor modulators reduced symptoms of hypoestrenogemia and growth of tumer of the uterus.
Tags	fibromyoma, conservative myomectomy, gonadotropin-releasing hormone agonists, selective modulators of progesterone receptors, quality of life assessment, resistance index
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Publication of the article	«World of Medicine and Biology» №2(60), 2017 year, 022-024 pages, index UDK 618.14-006.03-055.2-08.