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1. Göçmen A, Kara IH, Karaca M: The effects of add-back therapy with tibolone on myoma uteri. Clin Exp Obstet Gynecol; 2002;29(3):222-4
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  • [Title] The effects of add-back therapy with tibolone on myoma uteri.
  • In this prospective, randomized, double-blind study, we evaluated the effects of tibolone therapy in association with preoperative gonadotropin releasing hormone agonist (GnRHa) therapy on the reduction of myoma volume.
  • Group I was given monthly triptoreline (3.75 mg every 28 days IM) treatment for six months.
  • As for group II, tibolone was added on to this treatment.
  • While the average volume of myoma was 72.97 +/- 68.5 cm3 in group I, 78.83 +/- 74.1 cm3 in group II before treatment; it was reduced to 29.91 +/- 27.8 cm3 in group I at the end of six months of treatment.
  • In group I the patients had the problem of flushing (80%), vaginal dryness (50%), and night sweats (30%).
  • [MeSH-major] Antineoplastic Agents, Hormonal / administration & dosage. Gonadotropin-Releasing Hormone / administration & dosage. Gonadotropin-Releasing Hormone / analogs & derivatives. Leiomyoma / drug therapy. Norpregnenes / administration & dosage. Triptorelin Pamoate / administration & dosage. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Double-Blind Method. Drug Therapy, Combination. Estradiol / blood. Female. Humans. Prospective Studies. Treatment Outcome

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  • (PMID = 12519049.001).
  • [ISSN] 0390-6663
  • [Journal-full-title] Clinical and experimental obstetrics & gynecology
  • [ISO-abbreviation] Clin Exp Obstet Gynecol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Norpregnenes; 33515-09-2 / Gonadotropin-Releasing Hormone; 4TI98Z838E / Estradiol; 57773-63-4 / Triptorelin Pamoate; 79561-22-1 / LHRH, Ala(6)-Gly(10)-ethylamide-; FF9X0205V2 / tibolone
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2. Steiner RA, Fink D: [Abnormal menstrual bleeding]. Praxis (Bern 1994); 2002 Nov 13;91(46):1967-74
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  • The diagnostic work-up is essentially based on the vaginal ultrasound.
  • Medical treatment is based on gestagens, estrogens or combinations thereof.
  • [MeSH-minor] Adolescent. Adult. Biopsy. Curettage. Drug Therapy, Combination. Endometrial Neoplasms / complications. Estrogens / administration & dosage. Estrogens / therapeutic use. Female. Humans. Hysterectomy. Hysteroscopy. Iatrogenic Disease. Leiomyoma / complications. Middle Aged. Polyps / complications. Pregnancy. Progestins / administration & dosage. Progestins / therapeutic use. Time Factors. Uterine Neoplasms / complications. Uterus / pathology

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  • (PMID = 12476602.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Estrogens; 0 / Progestins
  • [Number-of-references] 34
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3. Vural B, Ozkan S, Ciftçi E, Bodur H, Yücesoy I: Spontaneous vaginal expulsion of an infected necrotic cervical fibroid through a cervical fistula after uterine artery embolization: a case report. J Reprod Med; 2007 Jun;52(6):563-6
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  • [Title] Spontaneous vaginal expulsion of an infected necrotic cervical fibroid through a cervical fistula after uterine artery embolization: a case report.
  • BACKGROUND: Uterine artery embolization (UAE) is promising, minimally invasive therapy being offered to women for treatment of fibroids.
  • CASE: A patient treated with UAE for a huge cervical fibroid presented with an infected, necrotic cervical mass lesion 4 weeks after the procedure.
  • Spontaneous vaginal expulsion of the infected cervical fibroid from the left lateral cervical fistula tract occurred 3 weeks later while the patient was receiving antibiotic therapy.
  • The patient gave birth to a healthy, female infant following a spontaneous, uneventful pregnancy and vaginal delivery.
  • [MeSH-major] Embolization, Therapeutic / adverse effects. Fistula / etiology. Leiomyoma / therapy. Uterine Cervical Diseases / etiology. Uterine Neoplasms / therapy
  • [MeSH-minor] Adult. Anti-Bacterial Agents / therapeutic use. Cervix Uteri / pathology. Female. Humans. Necrosis / drug therapy. Uterus / blood supply. Vaginal Discharge


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4. Sadan O, Ginath S, Sofer D, Rotmensch S, Debby A, Glezerman M, Zakut H: The role of tamoxifen in the treatment of symptomatic uterine leiomyomata -- a pilot study. Eur J Obstet Gynecol Reprod Biol; 2001 Jun;96(2):183-6
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  • [Title] The role of tamoxifen in the treatment of symptomatic uterine leiomyomata -- a pilot study.
  • OBJECTIVES: To determine the efficacy of tamoxifen in patients with leiomyomata complaining of abdominal pains and vaginal bleeding.
  • All patients underwent serial pelvic and ultrasound exams and endometrial sampling was performed prior to initiation of treatment.
  • In the study group patients reported after 4 months of treatment a substantial decrease in the intensity of pain (P=0.018).
  • Seven patients in the study group and one patient in the control group developed ovarian cysts.
  • CONCLUSIONS: Treatment with tamoxifen added only marginal benefit while causing unacceptable side effects.
  • Tamoxifen does not seem to be a useful adjunct in the treatment of symptomatic uterine leiomyomata and its use for this indication should be discouraged.
  • [MeSH-major] Leiomyoma / drug therapy. Tamoxifen / therapeutic use. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Abdominal Pain. Adult. Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / therapeutic use. Double-Blind Method. Endometrium / ultrasonography. Female. Humans. Hysterectomy. Middle Aged. Ovarian Cysts / chemically induced. Pilot Projects. Placebos. Prospective Studies. Treatment Outcome. Uterine Hemorrhage / drug therapy

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  • (PMID = 11384804.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Placebos; 094ZI81Y45 / Tamoxifen
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5. Ustaalioglu BB, Bilici A, Seker M, Salman T, Gumus M, Barisik NO, Salepci T, Yaylaci M: Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy. Onkologie; 2009 Jul;32(7):424-6
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  • [Title] Metastasis of lobular breast carcinoma to the uterus in a patient under anastrozole therapy.
  • Lobular carcinoma is the most common type of breast cancer that metastasizes to the uterus.
  • CASE REPORT: We report on a 56-year-old woman who 3 years previously was diagnosed with invasive lobular carcinoma of the breast and was treated with surgery followed by chemotherapy and radiotherapy.
  • While the patient was on adjuvant anastrozole therapy for 2 years, she complained of vaginal bleeding.
  • Because of endometrial thickening and a uterine leiomyoma detected during abdominal ultrasonographic ex-amination, a total hysterectomy with bilateral salpingo-oophorectomy was performed.
  • CONCLUSION: To our knowledge, this is the second case of lobular breast carcinoma metastasized to the uterus under anastrozole therapy.
  • In women with lobular breast cancer under adjuvant anastrozole therapy, who present with vaginal bleeding, uterine metastasis of lobular carcinoma should be considered in the differential diagnosis.
  • [MeSH-major] Breast Neoplasms / complications. Breast Neoplasms / drug therapy. Carcinoma, Lobular / chemically induced. Carcinoma, Lobular / secondary. Nitriles / adverse effects. Nitriles / therapeutic use. Triazoles / adverse effects. Triazoles / therapeutic use. Uterine Neoplasms / chemically induced. Uterine Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / therapeutic use. Diagnosis, Differential. Female. Humans. Middle Aged

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19556822.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Nitriles; 0 / Triazoles; 2Z07MYW1AZ / anastrozole
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6. Lee SL, Huang LW, Chang JZ, Hwang JL, Pan HS: Pelvic abscess after laparoscopic myomectomy with vaginal extraction. Taiwan J Obstet Gynecol; 2010 Dec;49(4):528-30
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  • [Title] Pelvic abscess after laparoscopic myomectomy with vaginal extraction.
  • [MeSH-major] Abscess / microbiology. Enterococcus / isolation & purification. Laparoscopy / adverse effects. Leiomyoma / surgery. Pelvis / microbiology. Uterine Neoplasms / surgery
  • [MeSH-minor] Female. Humans. Middle Aged. Postoperative Complications / drug therapy. Postoperative Complications / surgery

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  • (PMID = 21199762.001).
  • [ISSN] 1875-6263
  • [Journal-full-title] Taiwanese journal of obstetrics & gynecology
  • [ISO-abbreviation] Taiwan J Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] China
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7. Ma SK, Zhang HT, Wu LY, Liu LY, Li B: [Treatment and prognosis of low-grade malignant endometrial stromal sarcoma]. Zhonghua Zhong Liu Za Zhi; 2007 Jan;29(1):74-8
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  • [Title] [Treatment and prognosis of low-grade malignant endometrial stromal sarcoma].
  • OBJECTIVE: To review the experience in the treatment of low-grade malignant endometrial stromal sarcoma.
  • RESULTS: Of these 41 patients, 24 suffered from irregular vaginal bleeding, and 30 had been diagnosed to have leiomyoma before treatment.
  • Thirty-three patients received postoperative adjuvant therapy including radiation and/or chemotherapy.
  • 9%) developed recurrent disease, most of which in the pelvis.
  • The mean time to recurrence was 31 months (range 6 to 78 months) with the median time of 26 months.
  • Patients who received adjuvant therapy had a lower recurrent rate (30.
  • CONCLUSION: Low-grade malignant endometrial stromal sarcoma has a good prognoses though dwarfed by higher late recurrence after initial treatment.
  • [MeSH-major] Endometrial Neoplasms / therapy. Lung Neoplasms / therapy. Sarcoma, Endometrial Stromal / therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brachytherapy / methods. Cesium Radioisotopes / therapeutic use. Chemotherapy, Adjuvant / methods. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Hysterectomy / methods. Kaplan-Meier Estimate. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Radiotherapy, Adjuvant / methods. Retrospective Studies

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  • (PMID = 17575701.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Cesium Radioisotopes
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8. Chang FW, Yu MH, Ku CH, Chen CH, Wu GJ, Liu JY: Effect of uterotonics on intra-operative blood loss during laparoscopy-assisted vaginal hysterectomy: a randomised controlled trial. BJOG; 2006 Jan;113(1):47-52
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  • [Title] Effect of uterotonics on intra-operative blood loss during laparoscopy-assisted vaginal hysterectomy: a randomised controlled trial.
  • OBJECTIVE: To investigate the effectiveness of uterotonics misoprostol and oxytocin on reducing blood loss during laparoscopy-assisted vaginal hysterectomy (LAVH).
  • Mean [SD] for all continuous data estimated weight of blood loss (198.1 [123.2] vs 396 [337.6] g; P < 0.0001), mean operation time (106.2 [39.4] vs 116.6 [34.6] minutes; P = 0.02), mean change in haemoglobin (1.5 [1.0] vs 1.9 [1.2] g/dL; P = 0.02) and haematocrit levels (4.8 [2.9]% vs 5.8 [3.6]%; P = 0.04) and mean hospitalisation period (3.3 [0.8] vs 3.9 [1.1] days; P < 0.0001), which were significantly less in the group given rectal misoprostol and intravenous oxytocin than in the placebo group, respectively.
  • CONCLUSION: Combined rectal misoprostol and intravenous oxytocin is a feasible and effective method of reducing blood loss and operation time in LAVH.
  • [MeSH-major] Blood Loss, Surgical / prevention & control. Hysterectomy, Vaginal / methods. Laparoscopy / methods. Misoprostol / administration & dosage. Oxytocics / administration & dosage. Oxytocin / administration & dosage
  • [MeSH-minor] Administration, Rectal. Adult. Drug Therapy, Combination. Female. Humans. Infusions, Intravenous. Leiomyoma / surgery. Length of Stay. Middle Aged. Pregnancy. Treatment Outcome. Uterine Neoplasms / surgery

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  • (PMID = 16398771.001).
  • [ISSN] 1470-0328
  • [Journal-full-title] BJOG : an international journal of obstetrics and gynaecology
  • [ISO-abbreviation] BJOG
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Oxytocics; 0E43V0BB57 / Misoprostol; 50-56-6 / Oxytocin
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9. Taşkin EA, Taşkin S, Berker B, Erol E, Dünder I, Söylemez F: Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome. Arch Gynecol Obstet; 2008 Jan;277(1):71-3
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  • [Title] Aggressive mixed type endometrial carcinoma in a young woman with rapid progression and fatal outcome.
  • INTRODUCTION: Endometrial carcinoma in young ages is uncommon and tends to be a well differentiated endometrioid type and has an excellent prognosis.
  • Nevertheless, in this report mixed type endometrial cancer including serous, clear cell and endometrioid components in a young patient with rapid progression and fatal outcome is presented.
  • Transabdominal ultrasonography demonstrated 30 x 27 mm intramural mass consistent with leiomyoma in uterine corpus posterior.
  • The patient did not permit any vaginal intervention including endometrial sampling, therefore laparotomy was decided.
  • Mixed type endometrial carcinoma was diagnosed and she was treated with comprehensive surgery plus adjuvant chemotherapy.
  • [MeSH-minor] Adult. Anemia / etiology. Chemotherapy, Adjuvant. Fatal Outcome. Female. Humans. Menorrhagia / etiology. Neoplasm Invasiveness. Neoplasm Metastasis

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  • (PMID = 17639438.001).
  • [ISSN] 0932-0067
  • [Journal-full-title] Archives of gynecology and obstetrics
  • [ISO-abbreviation] Arch. Gynecol. Obstet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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10. Pullè C, Sturlese E: Clinical trial comparing the activity and efficacy of ibuprofen isobutanolammonium vs Benzydamine hydrochloride, applied as vaginal irrigations, in patients with vaginitis. Clin Exp Obstet Gynecol; 2002;29(3):173-9
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  • [Title] Clinical trial comparing the activity and efficacy of ibuprofen isobutanolammonium vs Benzydamine hydrochloride, applied as vaginal irrigations, in patients with vaginitis.
  • This study was conducted on 30 female patients (average age: 40.5 +/- 11 years, age range 19-65), affected by vulval and/or vaginal phlogosis with a prevalence of uterine fibromyomatosis and metrorrhagia of a varied nature.
  • Fifteen patients were assigned to the treatment with Ibuprofen isobutanolammonium and 15 to the treatment with Benzydamine hydrochloride.
  • Both the subjective symptoms (burning and itching) and the objective symptoms (erythema, oedema, exudation) showed a marked reduction as early as the third day of treatment and the comparison between the score at the start of treatment and on day three of the treatment was highly significant in both study groups (p < 0.01).
  • [MeSH-major] Benzydamine / administration & dosage. Ibuprofen / administration & dosage. Vaginitis / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Leiomyoma / drug therapy. Middle Aged. Therapeutic Irrigation. Uterine Neoplasms / drug therapy. Vulvitis / drug therapy

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  • (PMID = 12519036.001).
  • [ISSN] 0390-6663
  • [Journal-full-title] Clinical and experimental obstetrics & gynecology
  • [ISO-abbreviation] Clin Exp Obstet Gynecol
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 4O21U048EF / Benzydamine; WK2XYI10QM / Ibuprofen
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11. Lam MM, Corless CL, Goldblum JR, Heinrich MC, Downs-Kelly E, Rubin BP: Extragastrointestinal stromal tumors presenting as vulvovaginal/rectovaginal septal masses: a diagnostic pitfall. Int J Gynecol Pathol; 2006 Jul;25(3):288-92
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  • The original diagnoses were leiomyoma in one case and leiomyosarcoma in 2 cases.
  • The lesions were localized to the rectovaginal septum () or vagina () and ranged from 4 to 8 cm in diameter.
  • Misdiagnosis may lead to inappropriate therapy because conventional chemotherapy and radiotherapy are not effective in the treatment of GISTs, whereas imatinib mesylate (Gleevec, Glivec) has a proven role in managing these tumors.
  • [MeSH-major] Gastrointestinal Stromal Tumors / diagnosis. Rectal Neoplasms / diagnosis. Vaginal Neoplasms / diagnosis. Vulvar Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antigens, CD34 / analysis. Antineoplastic Agents / therapeutic use. Benzamides. DNA, Neoplasm / genetics. Diagnosis, Differential. Female. Humans. Imatinib Mesylate. Immunohistochemistry. Leiomyoma / chemistry. Leiomyoma / diagnosis. Leiomyoma / genetics. Leiomyoma / pathology. Leiomyosarcoma / chemistry. Leiomyosarcoma / diagnosis. Leiomyosarcoma / genetics. Leiomyosarcoma / pathology. Middle Aged. Mutation / genetics. Piperazines / therapeutic use. Proto-Oncogene Proteins c-kit / analysis. Proto-Oncogene Proteins c-kit / genetics. Pyrimidines / therapeutic use

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  • (PMID = 16810068.001).
  • [ISSN] 0277-1691
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD34; 0 / Antineoplastic Agents; 0 / Benzamides; 0 / DNA, Neoplasm; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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12. Lethaby A, Vollenhoven B, Sowter M: Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev; 2001;(2):CD000547
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  • [Title] Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids.
  • Although some of these tumours are asymptomatic, up to 50% cause symptoms severe enough to warrant therapy and surgery is the standard treatment.
  • Fibroid growth is stimulated by oestrogen and gonadotropin releasing hormone agonists (GnRHa) which induce a state of hypoestrogenism have been investigated as a potential treatment.
  • GnRHa treatment causes fibroids to shrink but cannot be used long term because of unacceptable symptoms and bone loss.
  • OBJECTIVES: The objective of this review is to evaluate the role of pre-treatment with gonadotropin releasing hormone (GnRH) analogues prior to a major surgical procedure, either hysterectomy or myomectomy, for uterine fibroids.
  • Attempts were also made to identify published trials from citation lists of review articles and direct contact with drug companies for unpublished trials.
  • SELECTION CRITERIA: The inclusion criteria were randomised comparisons of GnRH analogue treatment versus placebo, no treatment, or other medical therapy prior to surgery, either myomectomy or hysterectomy, for uterine fibroids.
  • The reviewers extracted the data independently and odds ratios for dichotomous outcomes and weighted mean differences for continuous outcomes were estimated from the data of fourteen trials where GnRH analogue treatment was compared with no pre-treatment and six trials where GnRH analogue treatment was compared with placebo.
  • One RCT compared GnRHa pre-treatment with lynestrenol pre-treatment.
  • Results from pre-operative outcomes were combined for both types of surgery but results from intra- and post-operative outcomes were reported separately for myomectomy and hysterectomy.
  • Subgroup analysis was performed according to type of control group, no pre-treatment or placebo, and for some outcomes there were additional subgroup analyses according to size of the uterus in gestational weeks.
  • MAIN RESULTS: Pre- and post-operative haemoglobin (Hb) and haematocrit (HCT) were significantly improved by GnRH analogue therapy prior to surgery, and uterine volume, uterine gestational size and fibroid volume were all reduced.
  • Pelvic symptoms were also reduced but some adverse events were more likely during GnRH analogue therapy.
  • Hysterectomy appeared to be easier after pre-treatment with GnRH analogue therapy; there was reduced operating time and a greater proportion of hysterectomy patients were able to have a vaginal rather than an abdominal procedure.
  • Evidence of increased risk of fibroid recurrence after GnRH analogue pre-treatment in myomectomy patients was equivocal and few data were available to assess change in post-operative fertility.
  • Lynestrenol did not offer any advantage over GnRH analogue therapy before fibroid surgery.
  • The increased costs associated with GnRH analogue therapy were not assessed.
  • For patients undergoing hysterectomy, a vaginal procedure is more likely following the use of these agents.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Gonadotropin-Releasing Hormone / analogs & derivatives. Leiomyoma / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Hysterectomy. Myometrium / surgery. Randomized Controlled Trials as Topic

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  • [UpdateOf] Cochrane Database Syst Rev. 2000;(2):CD000547 [10796723.001]
  • [UpdateIn] Cochrane Database Syst Rev. 2017 Nov 15;11:CD000547 [29139105.001]
  • (PMID = 11405968.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 33515-09-2 / Gonadotropin-Releasing Hormone
  • [Number-of-references] 45
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13. Felberbaum RE, Küpker W, Diedrich K: Will GnRH antagonists assist in the treatment of benign gynaecological diseases? Reprod Biomed Online; 2002;5 Suppl 1:68-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Will GnRH antagonists assist in the treatment of benign gynaecological diseases?
  • While GnRH agonists have become well-established tools for preoperative treatment of uterine fibroids or postoperative treatment in endometriosis for 3-6 months, GnRH antagonists seem to offer important advantages due to their specific pharmacological mode of action.
  • Avoiding any flare-up effect, it seems to be possible to reduce treatment time to about only 2-4 weeks in the case of fibroids to obtain a clinically relevant reduction in size.
  • Endometriosis patients undergoing this treatment reported a symptom-free period, with no signs of mood changes, hot flushes, loss of libido, vaginal dryness or other symptoms.
  • Serum oestradiol oscillated around a mean level of 50 pg/ml during therapy.
  • Sequential administration of the GnRH antagonist cetrorelix (Cetrotide), in a 3 mg dosage once weekly over 8 weeks in the case of endometriosis or administration every 4th day for a time span of 2-4 weeks for fibroids, creates a new opportunity for medical treatment.
  • [MeSH-major] Endometriosis / drug therapy. Gonadotropin-Releasing Hormone / analogs & derivatives. Gonadotropin-Releasing Hormone / antagonists & inhibitors. Leiomyoma / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Female. Hormone Antagonists / therapeutic use. Humans. Neoplasms / drug therapy

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  • (PMID = 12537785.001).
  • [ISSN] 1472-6483
  • [Journal-full-title] Reproductive biomedicine online
  • [ISO-abbreviation] Reprod. Biomed. Online
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Hormone Antagonists; 33515-09-2 / Gonadotropin-Releasing Hormone; OON1HFZ4BA / cetrorelix
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14. Lethaby AE, Vollenhoven BJ: An evidence-based approach to hormonal therapies for premenopausal women with fibroids. Best Pract Res Clin Obstet Gynaecol; 2008 Apr;22(2):307-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An evidence-based approach to hormonal therapies for premenopausal women with fibroids.
  • This has provided a rationale for the investigation of hormonal therapies for women with fibroids.
  • This chapter will assess the role of hormonal therapies for pre-menopausal women with fibroids.
  • There is some evidence that add-back therapy, either progestagen, tibolone, combined oestrogen and progestagen, or raloxifene, can reduce the menopausal symptoms associated with GnRHa and/or loss of bone density, but there is insufficient good-quality research to make definitive conclusions.
  • Women undergoing hysterectomy are more likely to have a vaginal than an abdominal procedure.
  • Limited short-term evidence of two progestogenic therapies indicates that low-dose mifepristone may improve quality of life and bleeding in the short term, and asoprisinil may improve bleeding and fibroid-related symptoms.
  • In conclusion, more research is required on the role of hormonal therapies for women with fibroids, particularly add-back options and selective oestrogen and progesterone receptor modulators.
  • No definitive conclusions can be reached on the basis of the limited evidence found.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Leiomyoma / drug therapy. Uterine Neoplasms / drug therapy
  • [MeSH-minor] Drug Therapy, Combination. Estrogen Antagonists / therapeutic use. Evidence-Based Medicine. Female. Gonadotropin-Releasing Hormone / analogs & derivatives. Gonadotropin-Releasing Hormone / therapeutic use. Humans. Norpregnenes / therapeutic use. Premenopause. Progestins / therapeutic use. Raloxifene Hydrochloride / therapeutic use. Randomized Controlled Trials as Topic

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  • (PMID = 17905660.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Antagonists; 0 / Norpregnenes; 0 / Progestins; 33515-09-2 / Gonadotropin-Releasing Hormone; 4F86W47BR6 / Raloxifene Hydrochloride; FF9X0205V2 / tibolone
  • [Number-of-references] 57
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15. Istre O: Management of symptomatic fibroids: conservative surgical treatment modalities other than abdominal or laparoscopic myomectomy. Best Pract Res Clin Obstet Gynaecol; 2008 Aug;22(4):735-47
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of symptomatic fibroids: conservative surgical treatment modalities other than abdominal or laparoscopic myomectomy.
  • However, until 15 years ago, the only surgical options available were hysterectomy and myomectomy, and as yet there are no proven effective long-term medical therapies.
  • Fortunately, the past decade has witnessed the emergence of highly sophisticated diagnostic and therapeutic technologies for fibroids.
  • The new treatment modalities include: laparoscopic and vaginal myomectomy; uterine artery embolization (UAE); magnetic-resonance-guided focused ultrasound surgery (MRgFUS); hysteroscopic resection where the fibroids are submucous; myolysis by heat, cold coagulation and laser; laparoscopic uterine artery occlusion; and temporary transvaginal uterine artery occlusion.
  • It is, however, abundantly clear that there is no panacea that suits every woman, nor are all treatment types universally available to all women, even in the developed world.
  • Much the same applies to vaginal myomectomy.
  • UAE is now widely used in the USA and Western Europe, and has been recommended by the National Institute for Clincial Excellence (NICE) in the UK as an alternative therapy to hysterectomy.
  • UAE has a range of complications including premature ovarian failure, chronic vaginal discharge and pelvic sepsis, and may have limited efficacy when the fibroids are large.
  • MRgFUS was approved by the US Food and Drug Administration in 2004, while NICE recommended that the procedure should be used in an audit and research setting.
  • Thus there is no room for complacency; research involving the available treatment modalities is urgently needed, while innovations in search of newer and more effective therapies must continue.
  • This chapter will review surgical treatment modalities other than hysterectomy and abdominal or laparoscopic myomectomy.
  • [MeSH-major] Leiomyoma / therapy. Uterine Neoplasms / therapy
  • [MeSH-minor] Female. Humans. Hysteroscopy / methods. Laparoscopy / methods. Myometrium / surgery. Ultrasonic Therapy / methods. Uterine Artery Embolization / methods

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  • (PMID = 18328788.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 46
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16. Pauer HU, Viereck V, Burfeind P, Emons G, Krauss T: Uterine cervical metastasis of breast cancer: a rare complication that may be overlooked. Onkologie; 2003 Feb;26(1):58-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Subsequently, the patient received 6 cycles of chemotherapy with cyclophosphamide, methotrexate and fluorouracil.
  • 14 months after treatment the patient presented with an axillary relapse and surgery, second-line chemotherapy with doxorubicine and radiation therapy of the chest wall and the axilla were performed.
  • The patient developed liver metastases 14 months later and at this time ultrasonographic pelvic examination revealed a 2.2 cm tumour of the cervix with good vascularisation.
  • The patient had no clinical symptoms, i.e. no vaginal bleeding or discharge.
  • Sonomorphologically this tumour appeared as a leiomyoma of the cervix.
  • Under palliative chemotherapy with docetaxel progression of liver metastases and cervical metastasis occurred and the patient died 9 months later.
  • CONCLUSION: Metastatic involvement of the cervix should be considered in women with a history of breast cancer who present with vaginal bleeding or suspicious changes of the cervix on transvaginal ultrasound.


17. Ajit D, Gavas S, Jagtap S, Chinoy RF: Cytodiagnostic problems in cervicovaginal smears from symptomatic breast cancer patients on tamoxifen therapy. Acta Cytol; 2009 Jul-Aug;53(4):383-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cytodiagnostic problems in cervicovaginal smears from symptomatic breast cancer patients on tamoxifen therapy.
  • Of 4 patients with a cytodiagnosis of atypical glandular changes, 2 had negative histology; 1 each had a uterine leiomyoma and endometrial hyperplasia.
  • To avoid diagnostic errors, cervicovaginal smears should be repeated after discontinuing tamoxifen treatment.
  • Regular follow-up with cervicovaginal smears from patients on tamoxifen treatment is recommended.
  • [MeSH-major] Cervix Uteri / pathology. Tamoxifen / adverse effects. Uterine Cervical Neoplasms / pathology. Vagina / pathology. Vaginal Neoplasms / pathology. Vaginal Smears
  • [MeSH-minor] Adenocarcinoma / pathology. Adult. Aged. Antineoplastic Agents, Hormonal / adverse effects. Breast Neoplasms / drug therapy. Diagnosis, Differential. False Positive Reactions. Female. Humans. Middle Aged






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