M. Redecha, P. Papcun, M. Mižičková, V. Javorka, S. Redechová, M. Križko ml., I. Hollý, M. Gábor, M. Foltín, J. Záhumenský, K. Holomáň
Purpose: We compare two therapeutic managements for symptomatic myomas (uterine
artery embolization (UAE) vs. ulipristal acetate (UPA)).
Methods: From January 2013 till April 2016 80 patients, with symptomatic myomas
suitable for conservative treatment, were randomized in two arms, each with 40 patients.
In one we performed UAE and in the other administered 5 mg UPA for three
months. Patients were followed for 6 months after the beginning of the therapy.
Results: Myoma volume reduced in UPA arm by 22.4 %, (p<0.001, CI 95%) 6
months after the therapy. In UAE arm, the volume reduced by 39.7 % (p<0.001, CI
95%). Bigger myoma volume reduction was in UAE group (difference of 17.22 %),
(p<0.001, CI 95%). There was no statistical difference between groups in the number
of pads used during the menstruation (14.6 pads in UPA group and 16.1 in UAE
group (p=0.65, CI 95 %)). There was no difference in the percentage of patients with
physiological levels of haemoglobin (≥ 120 g/l) in the 6th month after the therapy (UPA
vs. UAE, 94.15 % vs. 89.51 % respectively, p=1.05 CI 95 %). The haemoglobin level
and regular menstruation cycle restored faster in the UPA arm. The pain score was
significantly lower in the UPA group than in UAE. There were no serious complications
during the study in both arms.
Conclusions: The UPA therapy and UAE represent conservative therapeutic approach
in the management of uterine fibroids. UPA administration reaches normal haemoglobin
levels and reduces pain faster than UAE and enables safer possible operation.
UAE is more effective in the myoma volume reduction.