Relugolix combination therapy and symptoms of uterine myomatosis – selected case reports of indication spectrum and treatment outcomes

Česká verze

Authors: R. Hudeček ¹ ; Jaroslav Klát ² ; K. Pohl ³; A. Prokopenko ⁴; L. Mikulášek ⁵ ; S. Šimová ¹ ; P. Krčál ⁶; A. Ševčík ⁷; P. Tomeš ⁸
Authors place of work: Gynekologicko-porodnická klinika LF MU a FN Brno ¹; Gynekologicko-porodnická klinika FN Ostrava ²; Gynekologická ambulance GYNPOHL s. r. o., Poliklinika ALTES, Kralupy nad Vltavou ³; Soukromá gynekologicko-porodnická ordinace, HEBEMED, Praha ⁴; Centrum Minimálně Invazivní Gynekologické Operativy (CMIGO), Reprodukční Medicíny (CRM), Endometriosy, Adenomyosy (CLEA) & Centrum Léčby Myomů (CLM), Praha ⁵; Gynekologie MU Dr. Krčál, s. r. o., Gynekologická ordinace Chlumčany, Chotěšov ⁶; Gynekologická ambulance, Jihlava ⁷; Ambulance pro léčbu myomatózy a endometriózy FN Plzeň ⁸
Published in the journal: Ceska Gynekol 2023; 88(5): 359-370
Category: Soubor komentovaných kazuitstik
doi: https://doi.org/10.48095/cccg2023359

Summary

Objective: An illustrative review of the indications for relugolix combination therapy (RCT) in the management of symptoms associated with uterine myomatosis. Methods: A set of annotated case reports from outpatient and clinical practice. Results: The file includes a non-invasive methodology for defining excessive menstrual bleeding using the pictorial bleeding assessment chart (PBAC). It also presents the use of RCT as a fertility-sparing procedure prior to elective myomectomy and the management of isthmic fibroids as an uterine factor of infertility. Cases of RCT of adenomyosis in primary sterility and in extragenital forms of endometriosis are commented. Emergent events associated with complications of myomatosis in pregnancy are represented by a case report of necrotizing diff use myomatosis in puerperium. The differential-diagnostic confusion of adnexal pathology and myomatosis, RCT as a final solution to failed pharmacotherapy, and the alternative of hysterectomy in premenopause illustrate the diverse spectrum of indications for pharmacological treatment, including the possibility of dual therapy with RCT and aGnRH. Conclusion: Relugolix combination therapy as an effective and safe causal treatment expands the therapeutic spectrum and options for reproductive medicine specialists and registering gynaecologists. The availability of conservative treatment in combination with surgical treatment leads to optimalization and greater effectiveness of therapeutic procedures and increased quality of life for women with myomatosis.

Keywords:

relugolix combination therapy – uterine fibroid symptoms

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