Place de la myomectomie chez une patiente en situation d’infertilité

Bendifallah, Sofiane; Brun, Jean Luc; Fernandez, H.

doi:10.1016/j.jgyn.2011.09.014

Cited by 18 publications

(2 citation statements)

References 65 publications

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“…Uterine fibroids are common benign tumours in women of childbearing age. They affect between 25 and 40% of women during periods of genital activity [1,2]. Myomectomy tends to be invasive and expensive; its benefit is to improve the quality of patients' lives and is more in demand in women who want to keep their uterus [3].…”

Section: Introductionmentioning

confidence: 99%

Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)

Emery¹,

César²,

Jostin³

et al. 2019

JGO

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To describe the epidemiological profile of patients, list myomectomy indications and report their prognosis at Loandjili General Hospital. A descriptive cross-sectional study conducted from 1 January 2016 to 31 December 2018 in the Gynecology Department of Loandjili General Hospital, including exhaustively all patients operated for myomectomy. The variables studied were pre (age, gestity, parity, indication), per (myoma measures, blood loss, intraoperative transfusion, complications and peroperative incidents) and postoperatively (hospital stay). Ninety-two patients had been received for surgical management of uterine fibroids out of a total of 1,455 gynecological procedures or 6.3%. The median age was 36.5 years [range 27 -44] with a peak in the 36 to 40 age group (37%). The median gestity and parity were respectively 2 [range 0 -12] and 1 [range 0 -7]. More than half of the patients were nulliparous (51.1%). In 71.7% of cases (n = 66), myomectomy was performed in a context of desire for maternity. Indications for myomectomy were hemorrhage (46.7%), large uterus above the umbilicus (37%) and pelvic pain (16.3%). The polymyomectomy was performed in 64.1% of the cases (n = 59) with nuclei of size varying between 2 and 20 cm. The morbidity was marked on the one hand by anemia (n = 14 or 14%) secondary to an intraoperative haemorrhage which resulted in two cases in performing a hemostatic hysterectomy and in the other by rupture of the uterine cavity. Postoperative blood loss was estimated at 200 to 1400 ml, resulting in more than half of the patients receiving blood transfusions (58%). Myomectomy by laparotomy is often accompanied by significant blood spoliation thus increasing the postoperative morbidity. Techniques that minimize intraoperative blood loss should be used for laparotomy myomectomy.

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Section: Introductionmentioning

confidence: 99%

Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)

Emery¹,

César²,

Jostin³

et al. 2019

JGO

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“…Patients with symptomatic leiomyomas often receive hormonal therapies, such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators, which have been proven to be effective at reducing leiomyoma volume, uterine size, and menstrual blood loss ( 8 ). Recently, pre-operative pharmacological treatment of myomas has been approved to control fibroid growth ( 9 , 10 ); Ulipristal acetate (UPA), a selective progesterone receptor modulator (SPRM) that modulates progesterone-receptor activity, is reported to have agonist/antagonist activities depending on the cellular context and has been demonstrated to induce apoptosis in cultured leiomyoma cells ( 11 ). Evidence suggests that long-term treatment with UPA may control the bleeding and shrinkage on uterine leiomyoma ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Ulipristal acetate induces cell cycle delay and remodeling of extracellular matrix

et al. 2018

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Uterine leiomyoma is a benign tumor that grows within the muscle tissue of the uterus. Ulipristal acetate (UPA) is a pre-operative drug used to reduce the size of leiomyoma. The aim of the present study was to examine the in vitro mechanistic details of action of UPA on uterine leiomyomas. Primary cultures of leiomyoma cells were isolated from patient myomectomy specimens and incubated in the presence or absence of UPA at various concentrations. The proliferation, cell viability and doubling time properties of the treated cells were analyzed. In addition, the mRNA and protein expression levels of p21, p27, cyclin E, cyclin-dependent kinase 2 (CDK2), matrix metalloproteinase (MMP)-2 and MMP-9 were examined, as well as the structure of F-actin in the primary-cultured leiomyoma cells. The results demonstrated that UPA exerted inhibitory effects on proliferation of primary-cultured leiomyoma cells. Expression of p21 and p27 was upregulated, while cyclin E and CDK2 were downregulated in UPA-treated primary-cultured leiomyoma cells. An increased expression of MMP-2 was observed in primary-cultured leiomyoma cells and a leiomyoma tissue sample of a patient with previous history of UPA treatment. Furthermore, a pronounced formation of F-actin stress fibers was observed in leiomyoma cells of the UPA-treated patient. These data suggest that UPA treatment attenuated the proliferation of uterine fibroid cells via upregulation of p21 and p27, resulting in cell cycle delay. The findings in the current study also suggest that UPA may cause extracellular matrix constriction, leading to the shrinkage in size of the leiomyoma possibly via stimulation of MMP-2 expression and induction of actin stress fibers.

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Fertility, pregnancy outcomes and deliveries following myomectomy: experience of a French Caribbean University Hospital

Mozota

Kadhel

Janky

2013

Arch Gynecol Obstet

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Place de la myomectomie chez une patiente en situation d’infertilité

Cited by 18 publications

References 65 publications

Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)

Laparotomy Myomectomy: Epidemiology, Indications and Prognosis at Loandjili General Hospital (Republic of Congo)

Ulipristal acetate induces cell cycle delay and remodeling of extracellular matrix

Fertility, pregnancy outcomes and deliveries following myomectomy: experience of a French Caribbean University Hospital

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