Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL World Journal of Clinical Cases Pub Date : 2024-07-26 DOI:10.12998/wjcc.v12.i21.4601
De-Yu Zhang, Yan Huang, Chao Peng, Ying-Fang Zhou
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Abstract

Background: Currently, the use of dienogest in clinical practice has increased significantly, and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis; however, the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.

Aim: To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.

Methods: The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.

Results: The maximum uterine fibroid diameter and volume increased after 3 months, 6 months and 1 year of dienogest treatment compared with those before treatment (P < 0.01). The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment, but the difference was not significant (P > 0.05). Endometrial thickness and antigen 125 levels were significantly thinner and decreased, respectively, after dienogest treatment (P < 0.01). Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume (r = 0.792, P < 0.01). Among 64 patients with dysmenorrhea, 63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest, and all patients experienced significant relief of dysmenorrhea after 12 months. Patients were able to tolerate the drugs, with an average drug tolerance score of 8.73.

Conclusion: The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts, but it cannot inhibit uterine fibroid growth.

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地诺孕对子宫内膜异位症或子宫腺肌症并发子宫肌瘤患者子宫肌瘤体积的影响。
背景:目的:探讨地诺孕酮治疗子宫内膜异位症或子宫腺肌症合并子宫肌瘤患者肌瘤大小的变化,评价药物的有效性和安全性:回顾性分析北京大学第一医院2021年1月至2023年1月使用地诺孕酮治疗子宫内膜异位症或子宫腺肌症的子宫肌瘤患者的临床资料:与治疗前相比,地诺孕酮治疗3个月、6个月和1年后子宫肌瘤的最大直径和体积均有所增加(P < 0.01)。与治疗前相比,子宫腺肌瘤的最大直径和体积在地诺孕酮治疗 3 个月后有所增加,但在治疗 6 个月和 1 年后有所减少,但差异不显著(P > 0.05)。地诺孕酮治疗后,子宫内膜厚度和抗原 125 水平分别明显变薄和降低(P < 0.01)。皮尔逊相关分析显示,地诺孕酮治疗 3 个月后子宫肌瘤体积的增加与基本子宫肌瘤体积呈正相关(r = 0.792,P < 0.01)。在 64 名痛经患者中,63 人在使用地诺孕酮治疗 6 个月后痛经症状明显缓解,所有患者在使用地诺孕酮治疗 12 个月后痛经症状明显缓解。患者对药物的耐受性良好,平均药物耐受性评分为 8.73 分:子宫内膜异位症或子宫腺肌症合并子宫肌瘤患者使用地诺孕酮能有效缓解患者的疼痛症状,并能明显缩小卵巢子宫内膜异位囊肿的大小,但不能抑制子宫肌瘤的生长。
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World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
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期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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