Open AccessInfluence of Ulipristal Acetate in 3D-PW-Doppler parameters of patients with uterine myomas: a prospective observational pilot study
Author(s) -
Patricia Diaz Ortega,
Manuel García-Manero
Publication year - 2020
Language(s) - English
DOI - 10.36811/ojgor.2020.110014
Subject(s) - ulipristal acetate , medicine , uterine fibroids , myoma , ultrasound , urology , prospective cohort study , leiomyoma , radiology , observational study , gynecology , uterus , population , environmental health , family planning , research methodology
uterine fibroids are the most common benign tumors of the female genital tract. They associate a varied symptomatology, from the absence of symptoms to more disabling bleeding or pain [1,2]. There are multiple treatments directed against different targets such as ulipristal acetate which has proven effective in reducing the size of the fibroids and their symptoms [7]. Our preliminary study seeks to find the relationship between ulipristal acetate and angiogenesis of uterine fibroids, by measuring ultrasound vascularization of the fibroid throughout the treatment.Material and Methods: A prospective observational study has been designed, in which 24 patients with symptomatic uterine fibroids have been included and given 4 cycles of Ulipristal Acetate. The size and vascularization of the fibroids were measured at the beginning and end of treatment; as well as on several occasions throughout the follow-up. Myoma vascularization was measured by power doppler 3D ultrasound through different parameters that define the vascularization in a more objective way: Vascularization Index (VI), Flow Rate (FR), Flow Vascularization Index (FVI).Result: A significant reduction in the size of the fibroids has been observed, as well as their vascularization in terms of vascularization indices measured by 3D PW ultrasound. These changes were evident at the end of treatment and were maintained over time.Conclusion: There is a correlation between myoma vascularization and treatment with Ulipristal Acetate. SPRMs may provide effective treatment for women with symptomatic fibroids by two ways: supports selective progesterone receptor modulators and reduced angiogenesis. In addition, the use of vascularization markers of 3DPW ultrasound and the colour map allow us to monitor the response to medical treatment of myomas in a non-invasive and easily reproducible way.Keywords: Ulipristal Acetate; Esmya®; Uterine fibroids; Angiogenesis; 3D Power Doppler Ultrasound