Our Summary

Uterine leiomyomas, or fibroids, are common non-cancerous tumors that develop in the reproductive tract. This study looks at the use of a drug named Ulipristal Acetate (UPA) before a specific surgical procedure (hysteroscopic myomectomy) used to remove these fibroids. Researchers reviewed past studies to see if using UPA before the surgery affected the surgical outcomes. They found that UPA didn’t make the surgery more difficult. In fact, it might increase the chances of completely removing the fibroids in more complicated surgeries. However, they caution that the quality of evidence to support these findings is low. More high-quality studies are needed to better understand the impact of UPA on the surgery. They also suggest looking into the long-term effects of surgeries performed after UPA treatment, such as whether fibroids come back, how long recovery takes, and the patient’s quality of life.

FAQs

  1. What is Ulipristal Acetate (UPA) and how is it used in relation to fibroid treatment?
  2. Does the use of Ulipristal Acetate (UPA) before a hysteroscopic myomectomy make the surgery more complicated?
  3. What are the potential long-term effects of surgeries performed after UPA treatment?

Doctor’s Tip

A doctor might advise a patient undergoing myomectomy to consider discussing the use of Ulipristal Acetate (UPA) with them before the surgery. This drug may help improve surgical outcomes, especially in more complicated cases. However, it is important to note that more research is needed to fully understand the impact of UPA on myomectomy procedures. Patients should also inquire about potential long-term effects and recovery times associated with using UPA before surgery.

Suitable For

Typically, patients who are recommended for myomectomy are those who have symptomatic fibroids that are causing heavy menstrual bleeding, pelvic pain or pressure, urinary frequency, or infertility. Myomectomy is often recommended for women who want to preserve their fertility or who are not candidates for other treatments such as uterine artery embolization or hysterectomy. It is important for patients to discuss their individual situation with their healthcare provider to determine if myomectomy is the right treatment option for them.

Timeline

  • Patient first experiences symptoms such as heavy menstrual bleeding, pelvic pain, and pressure
  • Patient visits their doctor and is diagnosed with uterine fibroids through imaging tests
  • Patient discusses treatment options with their doctor, including myomectomy
  • Patient undergoes pre-operative evaluation and may be prescribed Ulipristal Acetate (UPA) to shrink the fibroids before surgery
  • Patient undergoes hysteroscopic myomectomy procedure to remove the fibroids
  • Patient may experience a quicker and more successful surgery with the use of UPA
  • Patient recovers from surgery and may experience improvements in symptoms such as reduced menstrual bleeding and pain
  • Patient follows up with their doctor for post-operative care and monitoring to ensure the fibroids do not return and to assess long-term outcomes and quality of life.

What to Ask Your Doctor

  1. Is hysteroscopic myomectomy the best option for me to remove my fibroids?
  2. What are the potential risks and complications associated with myomectomy?
  3. How will using Ulipristal Acetate (UPA) before surgery affect my surgical outcome?
  4. Are there any specific precautions or considerations I should be aware of if I choose to use UPA before myomectomy?
  5. How long is the recovery process expected to take after myomectomy, especially if I use UPA before surgery?
  6. Are there any long-term effects or potential complications I should be aware of following myomectomy with or without UPA treatment?
  7. Will my fertility be affected by undergoing myomectomy with UPA treatment?
  8. Are there any alternative treatment options I should consider for my fibroids?
  9. How often do fibroids come back after myomectomy, and what can I do to prevent their recurrence?
  10. What can I expect in terms of my quality of life and overall well-being after undergoing myomectomy with or without UPA treatment?

Reference

Authors: Vitale SG, Ferrero S, Caruso S, Barra F, Marín-Buck A, Vilos GA, Vitagliano A, Török P, Ciebiera M, Cianci A. Journal: Obstet Gynecol Surv. 2020 Feb;75(2):127-135. doi: 10.1097/OGX.0000000000000764. PMID: 32105337