Conservative treatment of diffuse uterine leiomyomatosis

Luigi Fedele, Stefano Bianchi, Giovanni Zanconato, Silvestro Carinelli, Nicola Berlanda

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To describe the conservative treatment of diffuse uterine leiomyomatosis. Design Descriptive study. Setting Tertiary care centers. Patient(s) Three premenopausal women with diffuse uterine leiomyomatosis associated to persistent menorrhagia, two with desire of becoming pregnant and one with desire of preservation of the uterus. Intervention(s) Preoperative ultrasound showed symmetrically enlarged uteri with innumerable, poorly defined and small-sized (0.5-3 cm) myomas involving all the myometrium. An "extreme" myomectomy was performed in two cases, including the removal of a large portion of corporal myometrium. One patient was treated only medically with GnRH analogues (GnRH-a). Main outcome measure(s) Menstrual pattern and, when applicable, ability to conceive and pregnancy outcome. Result(s) Regular menses were restored in both patients who underwent surgery: one had no pregnancy desire and the other was not able to conceive after two IVF-ETs. The patient treated with GnRH-a conceived spontaneously as soon as medical treatment was discontinued; at 34 gestational weeks, an emergency cesarean section followed by hysterectomy was performed for vaginal bleeding and a healthy 2,400-g baby was born. Conclusion(s) Our experience supports the idea that a conservative approach to uterine leiomyomatosis may result in restoration of normal cycles and eventually in the birth of a viable fetus.

Original languageEnglish
Pages (from-to)450-453
Number of pages4
JournalFertility and Sterility
Volume82
Issue number2
DOIs
Publication statusPublished - Aug 2004

Keywords

  • Diffuse uterine leiomyomatosis
  • GnRH analogues
  • uterine bleeding
  • uterine myomectomy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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