Document Detail


Comparison of surgery alone and combined surgical-medical treatment in the management of symptomatic uterine adenomyoma.
MedLine Citation:
PMID:  18774566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy of surgical-medical treatment and surgery alone in the treatment of uterine symptomatic adenomyoma. DESIGN: Prospective nonrandomized study. SETTING: Medical centers. PATIENT(S): One hundred sixty-five women treated with conservative adenomyomectomy. INTERVENTION(S): Surgery followed by six-course treatment (n = 114, surgical-medical group) or no treatment (n = 51, surgery-alone group) with a gonadotropin-releasing hormone (GnRH) agonist regimen. MAIN OUTCOME MEASURE(S): Symptom relief (scale: 0, no symptoms, to 5, worst symptoms) and relapse (when any one scale was > or =2 after treatment) during the 2-year follow-up period. RESULT(S): The general characteristics of the patients were similar in both groups, except for the diameter of the adenomyoma and age. Patients in both groups had statistically significant symptom relief, and all symptom scores declined from a mean of 3 or 4 to a mean of 1 or less at the end of the 2-year follow-up period. The symptom-relapse rates in the surgical-medical group were statistically significantly lower than those in the surgery alone group (n = 32, 28.1% vs. n = 25, 49.0%, respectively). CONCLUSION(S): Conservative surgery, regardless of GnRH agonist treatment, may be acceptable for management of a selected population with severe symptomatic adenomyoma. However, surgical-medical treatment provided more effective symptom control (a lower symptom relapse rate) than surgery alone during the 2-year follow-up period.
Authors:
Peng-Hui Wang; Wei-Min Liu; Jong-Ling Fuh; Ming-Huei Cheng; Hsiang-Tai Chao
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-06
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-31     Completed Date:  2009-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  876-85     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan. phwang@vghtpe.gov.tw
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MeSH Terms
Descriptor/Qualifier:
Adenomyoma / drug therapy*,  surgery*
Adult
Combined Modality Therapy
Female
Follow-Up Studies
Gonadotropin-Releasing Hormone / agonists*
Gynecologic Surgical Procedures / methods
Humans
Leuprolide / therapeutic use
Middle Aged
Prospective Studies
Recurrence / prevention & control
Treatment Outcome
Uterine Neoplasms / drug therapy*,  surgery*
Chemical
Reg. No./Substance:
33515-09-2/Gonadotropin-Releasing Hormone; 53714-56-0/Leuprolide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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