Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan
Introduction: Uterine fibroids are the most common benign tumor in women in Kazakhstan. In the past two decades, endoscopic surgery has played an important role in the development of gynecologic surgery, particularly in the treatment of uterine fibroids. The goal of this paper is to evaluate whether...
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| Format: | Article |
| Language: | English |
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University Library System, University of Pittsburgh
2015-09-01
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| Series: | Central Asian Journal of Global Health |
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| Online Access: | http://cajgh.pitt.edu/ojs/index.php/cajgh/article/view/232 |
| _version_ | 1819261105092952064 |
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| author | Balkenzhe Imankulova Alibek Mereke Nazira Kamzaeva Talshyn Ukybassova |
| author_facet | Balkenzhe Imankulova Alibek Mereke Nazira Kamzaeva Talshyn Ukybassova |
| author_sort | Balkenzhe Imankulova |
| collection | DOAJ |
| description | Introduction: Uterine fibroids are the most common benign tumor in women in Kazakhstan. In the past two decades, endoscopic surgery has played an important role in the development of gynecologic surgery, particularly in the treatment of uterine fibroids. The goal of this paper is to evaluate whether uterine artery embolization (UAE) or gonadotropin-releasing hormone agonists (GnRHa) prior to myomectomy was more effective in decreasing fibroid size and improving surgical outcomes in a pilot study of women in Kazakhstan.
Methods: This pilot investigation included 24 patients separated into 2 groups: medication group (pre-treatment with GnRHa – 13 patients) and embolization group (pre-treatment with UAE – 11 patients). All patients had uterine fibroids, 3-10 cm in diameter, and were treated with myomectomy at the National Research Center for Maternal and Child Health, Astana, Kazakhstan. All patient data were obtained by a retrospective medical records review. Descriptive statistics were utilized to characterize participant demographics data. Independent t-tests were used to analyze continuous variables, and Chi-square and Fisher’s exact tests were used where appropriate for count data.
Results: The group treated with GnRHa had an operating time of 40±10 minutes longer than the group treated with UAE, due to the peri-operative difficulties encountered by surgeons in detecting the layer between the myometrium and fibroid capsule. The group treated with UAE experienced better patient outcomes (less blood loss, less surgical time, and reduced use of anesthesia) and was a technically easier surgery due to visible differences in uterine layers.
Conclusions: Despite the fact that both treatments (GnRHa and UAE) were effective for fibroid shrinking, embolization resulted in more optimal surgical time and improved patient outcomes. Results of this pilot study need to be confirmed in a randomized clinical trial, specifically focused on Kazakhstan and the Central Asian Region. |
| first_indexed | 2024-12-23T19:36:30Z |
| format | Article |
| id | doaj.art-2ac0cc0bb4f6415688736f896de9b136 |
| institution | Directory Open Access Journal |
| issn | 2166-7403 |
| language | English |
| last_indexed | 2024-12-23T19:36:30Z |
| publishDate | 2015-09-01 |
| publisher | University Library System, University of Pittsburgh |
| record_format | Article |
| series | Central Asian Journal of Global Health |
| spelling | doaj.art-2ac0cc0bb4f6415688736f896de9b1362022-12-21T17:33:47ZengUniversity Library System, University of PittsburghCentral Asian Journal of Global Health2166-74032015-09-014110.5195/cajgh.2015.232125Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in KazakhstanBalkenzhe Imankulova0Alibek Mereke1Nazira Kamzaeva2Talshyn Ukybassova3Department of Obstetrics and Gynecology, National Research Center for Maternal and Child Health, National Medical Holding, AstanaDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PADepartment of Obstetrics and Gynecology, National Research Center for Maternal and Child Health, National Medical Holding, AstanaDepartment of Obstetrics and Gynecology, National Research Center for Maternal and Child Health, National Medical Holding, AstanaIntroduction: Uterine fibroids are the most common benign tumor in women in Kazakhstan. In the past two decades, endoscopic surgery has played an important role in the development of gynecologic surgery, particularly in the treatment of uterine fibroids. The goal of this paper is to evaluate whether uterine artery embolization (UAE) or gonadotropin-releasing hormone agonists (GnRHa) prior to myomectomy was more effective in decreasing fibroid size and improving surgical outcomes in a pilot study of women in Kazakhstan. Methods: This pilot investigation included 24 patients separated into 2 groups: medication group (pre-treatment with GnRHa – 13 patients) and embolization group (pre-treatment with UAE – 11 patients). All patients had uterine fibroids, 3-10 cm in diameter, and were treated with myomectomy at the National Research Center for Maternal and Child Health, Astana, Kazakhstan. All patient data were obtained by a retrospective medical records review. Descriptive statistics were utilized to characterize participant demographics data. Independent t-tests were used to analyze continuous variables, and Chi-square and Fisher’s exact tests were used where appropriate for count data. Results: The group treated with GnRHa had an operating time of 40±10 minutes longer than the group treated with UAE, due to the peri-operative difficulties encountered by surgeons in detecting the layer between the myometrium and fibroid capsule. The group treated with UAE experienced better patient outcomes (less blood loss, less surgical time, and reduced use of anesthesia) and was a technically easier surgery due to visible differences in uterine layers. Conclusions: Despite the fact that both treatments (GnRHa and UAE) were effective for fibroid shrinking, embolization resulted in more optimal surgical time and improved patient outcomes. Results of this pilot study need to be confirmed in a randomized clinical trial, specifically focused on Kazakhstan and the Central Asian Region.http://cajgh.pitt.edu/ojs/index.php/cajgh/article/view/232fibroidsKazakhstanGnRHauterine artery embolization |
| spellingShingle | Balkenzhe Imankulova Alibek Mereke Nazira Kamzaeva Talshyn Ukybassova Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan Central Asian Journal of Global Health fibroids Kazakhstan GnRHa uterine artery embolization |
| title | Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan |
| title_full | Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan |
| title_fullStr | Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan |
| title_full_unstemmed | Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan |
| title_short | Comparing the Use of Uterine Artery Embolization to Gonadotropin-Releasing Hormone Agonists in Shrinking Fibroid Size: A Pilot Study in Kazakhstan |
| title_sort | comparing the use of uterine artery embolization to gonadotropin releasing hormone agonists in shrinking fibroid size a pilot study in kazakhstan |
| topic | fibroids Kazakhstan GnRHa uterine artery embolization |
| url | http://cajgh.pitt.edu/ojs/index.php/cajgh/article/view/232 |
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