Terapia prechirurgica della fibromatosi uterina - FedOA - Università ...

Materials and methods
Thirty-three premenopausal women with single intramural symptomatic uterine leiomyoma referring
during the years 2005-2007 to the Department of Obstetrical–Gynaecological and Urological Science
and Reproductive Medicine of the University “Federico II” of Naples were enrolled in the study
group.
The patients (age 37.3±3.3 [SD]; parity 2.3±1.1 [SD]; BMI 24.1±4.9 [SD] Kg/m 2 ; myoma mean
diameter 7.64±0.7 [SD] cm) (GnRH-a group) received 3.75 mg triptorelin depot in three monthly
subcutaneous injections, starting within the first seven days of the menstrual cycle. After three weeks
at most from the end of the therapy, all the patients underwent myomectomy.
Twenty-nine premenopausal women (untreated group) (age 37.5±3.1 [SD]; parity 2.4±1.1 [SD]; BMI
25.4±4.8 [SD] Kg/m 2 ; myoma mean diameter 7.58±0.8 [SD] cm) did not receive any GnRH-a therapy
and underwent surgery during the follicular phase of the menstrual cycle.
Each patient gave her informed consent to be enrolled in the study.
No patient in either group took hormonal therapy or delivered within 12 months of the study or had
malignant neoplasm. Other exclusion criteria were previous pelvic surgery, uterine malformations,
present or past pelvic inflammatory disease, coagulation disorders and unstable general conditions.
Bimanual examination, transabdominal ultrasonography to calculate the myoma main diameter and
routine hematological tests were performed at the beginning of the study and after the pre-surgical
medical therapy.
Patients were submitted to laparotomic myomectomy. All procedures were performed by the same
staff, with a documented experience in gynecological abdominal surgery. The abdomen was opened
using a Pfannenstiel incision. Hysterotomy was carried out on the prominent part of the myoma.
Enucleation was made along the cleavage plan separating the myoma and the surrounding
myometrium. The hysterotomy was closed in one or two layers, using separate stitches of resorbable
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