Search

Selective progesterone receptor modulators (SPRMs) are synthetic steroid compounds that interact with the progesterone receptor, inducing various agonist, antagonist or mixed responses. First identified with mifepristone, they are now represented by ulipristal acetate (UPA), used for emergency contraception and uterine fibroids. Despite a few rare cases of severe hepatic insufficiency, SPRMs offer advantages in the treatment of uterine fibroids, reducing their volume without the hypoestrogenic side-effects of GnRH agonists, thus preserving patients' bone capital and quality of life. Despite temporary suspension of UPA administrated on a daily basis, research is exploring the potential of SPRMs in the management of endometriosis, adenomyosis and breast cancer. Despite certain concerns, SPRMs offer promising prospects in gynecological pathologies, opening up new therapeutic avenues to improve women's health and quality of life. This article describes the case of a patient with peritoneal leiomyomatosis for whom UPA significantly alleviated symptoms, reduced disease progression and improved quality of life, even allowing a pregnancy.

The anatomical localization of a myomatous nucleus is a determining factor in the occurrence of uterine fibromyomatous gravidal complications. These complications are mainly attributed to submucosal nuclei which lead to mechanical and vascular endometrial alterations and induce alterations of the stroma as atrophy or ulceration which reduces the chances of placental development. However, regular clinical and ultrasound monitoring, and management by a team that can cope with the various complications, is likely to promote up-toterm progress. The authors report a case of precious pregnancy coexisting with intracavitary myomatous nuclei up to term. They recall the possible complications of uterine leiomyomas on pregnancy and their mechanism of occurrence. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the prevalence of symptomatic uterine fibroid in France, related symptoms and its impact on quality of life., Materials and Methods: Online prospective survey from December 2012 to February 2013 using two questionnaires on 2498 women aged between 30 and 55 years old and representatives of the feminine population., Results: On the studied population, 220 women presented a symptomatic uterine fibroid representing a prevalence of 8.8%. 163 women (73.7%) presented bleedings associated or not with pain, and 58 (26.3%) suffered from pain only. For 77 (34.9%) women, the symptoms preceded the diagnostic and the mean delay between first symptoms and diagnostic was 2.22 years (ET : 3.56). At the time of the survey, 144 (65%) women with symptomatic uterine fibroid were followed by a physician (a gynecologist in 91.6% (n=132)), and 110 (49.7%) evaluated their pain as severe or extremely severe and 178 (80.6%) were bothered by their symptoms in their everyday life., Conclusion: This analysis shows a strong prevalence for symptomatic uterine fibroid with a major impact on the quality of life., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: Uterine fibroids are a common disorder, responsible for menorrhagia/metrorrhagia and pelvic pain and remain the leading reason for hysterectomy in France. Although it is common disorder, French epidemiological data are locking. The objective of this study was to realize an epidemiological analysis from the medicalized information system program (PMSI)., Materials and Methods: The diagnosis codes were selected from 10th version of the International Classification Disease. The medical procedures concerning uterine fibroids were selected (so called: procedures listed). A descriptive analysis was performed from hospitals stays, patients' characteristics and medical procedures (mean, standard distribution, median, range, quartile)., Results and Discussion: In 2012, 46,126 patients (median age: 46 years old) were admitted in hospital (public or private hospitals) due to uterine fibroid corresponding to 47,690 hospital stays (hospital stays for surgery: 32,397). Diagnosis of anemia was reported in approximately 8% of patients and 7.1% of patients hospitalized in 2012 had already been hospitalized between 2004-2012. The median length of hospital stay was 4 days. In 2012, 16,070 hospital stays were reported for total or subtotal hysterectomy, 16,384 hospitals stays for myomectomy and 1376 hospital stays for embolization. In terms of management care, among 46,126 patients with uterine fibroids (principal or related diagnosis), 31,846 patients received a procedure listed in a surgical diagnostic related groups (DRG)., Conclusion: To conclude, the study permits to update the epidemiological data concerning uterine fibroid management between 2010-2011-2012 in final. Because the PMSI collects partially information regarding epidemiological data, a clear epidemiological study is needed either with database from health insurance or with dedicated study., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)