Abstract:Hysterectomy for uterine leiomyomata can now be considered a safe procedure, but preoperative LHRH analogue administration greatly facilitates the surgical procedure, allowing myomectomy, when otherwise a hysterectomy may have been necessary. In selected cases, especially near the end of the reproductive period, LHRH analogues may become a valid alternative to hysterectomy.
“…Newer techniques to decrease adhesion formation include micro‐surgery 20 and the use of CO 2 , YAG or Argon lasers. Maheux 2 reports that lasers are unhelpful in laparotomic myomectomy. In contrast, others 21–23 believe that minimal blood loss, fewer adhesions and decreased anatomical disruption can improve long‐term results, especially in infertile patients.…”
“…Essentially, two approaches have been tried to maintain the good results obtained through the use of GnRH analogues, without maintaining women in a state of severe hypo‐oestroge‐nism. Friedman 34 and Maheux 2 have treated women with a GnRH analogue until the size of the uterus and that of leiomyo‐mas had properly diminished; at that stage, while continuing treatment with the analogue, they added small quantities of an oestrogen, followed by a progestogen, as in hormonal replacement therapy. In a pilot study, our group has added a progestogen alone.…”
Section: Management Of Women Who Have Completed Their Reproductive Cyclementioning
confidence: 99%
“…Since the first successful report of myomectomy in 1845 1 , treatment of uterine fibroids has been exclusively surgical although a variety of strange techniques has been used in the past 2 . Attempts to achieve a medical therapy of leiomyomas began in 1946 when Goodman 3 reported that administration of progesterone in seven women produced a decrease in the size of the tumour or of the uterus in all the patients, although Sega‐loff 4 failed to confirm this positive effect.…”
Section: Introductionmentioning
confidence: 99%
“…At least four comprehensive articles have recently reviewed the treatment options for leiomyomas 2,8–10 ; this paper will thus deal mostly with newer aspects that have not already been extensively covered.…”
“…Newer techniques to decrease adhesion formation include micro‐surgery 20 and the use of CO 2 , YAG or Argon lasers. Maheux 2 reports that lasers are unhelpful in laparotomic myomectomy. In contrast, others 21–23 believe that minimal blood loss, fewer adhesions and decreased anatomical disruption can improve long‐term results, especially in infertile patients.…”
“…Essentially, two approaches have been tried to maintain the good results obtained through the use of GnRH analogues, without maintaining women in a state of severe hypo‐oestroge‐nism. Friedman 34 and Maheux 2 have treated women with a GnRH analogue until the size of the uterus and that of leiomyo‐mas had properly diminished; at that stage, while continuing treatment with the analogue, they added small quantities of an oestrogen, followed by a progestogen, as in hormonal replacement therapy. In a pilot study, our group has added a progestogen alone.…”
Section: Management Of Women Who Have Completed Their Reproductive Cyclementioning
confidence: 99%
“…Since the first successful report of myomectomy in 1845 1 , treatment of uterine fibroids has been exclusively surgical although a variety of strange techniques has been used in the past 2 . Attempts to achieve a medical therapy of leiomyomas began in 1946 when Goodman 3 reported that administration of progesterone in seven women produced a decrease in the size of the tumour or of the uterus in all the patients, although Sega‐loff 4 failed to confirm this positive effect.…”
Section: Introductionmentioning
confidence: 99%
“…At least four comprehensive articles have recently reviewed the treatment options for leiomyomas 2,8–10 ; this paper will thus deal mostly with newer aspects that have not already been extensively covered.…”
“…This might be minimized by combined therapy. Preliminary experience of the combination of combined oestrogen‐progestogen hormone‐replacement therapy with goserelin appears to be promising 17,18 ; however, concern remains that the dose of steroids required to be bone sparing may, in some women, lead to fibroid regrowth and/or a return of menstrual symptoms. We have investigated two alternative approaches to medical management.…”
Section: Medical Treatment: Combined Therapymentioning
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