Safrai Myriam, Chill Henry H, Reuveni Salzman Adi, Shushan Asher
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Obstet Gynecol. 2017 Aug;130(2):315-318. doi: 10.1097/AOG.0000000000002143.
Uterine leiomyomas have drawn much attention since being described more than 200 years ago. These common benign uterine tumors often present with prolonged menstrual bleeding, pelvic pressure, and reproductive disorders and pose a true financial burden on health care systems all over the world. Over the past few decades, surgical treatment of uterine leiomyomas has received most of the focus compared with other treatment options. Choosing the appropriate surgical technique depends on many factors such as uterine leiomyoma location, patient's age, interest in future fertility, concomitant comorbidities, and the patient's preference. Pharmacologic treatments such as gonadotropin-releasing hormone agonists and antagonists have been used for the treatment of symptomatic uterine leiomyomas with only partial success. Myriad side effects and limited clinical results have rendered them less popular and have exposed a true need for new effective medical treatments. Recently, treatment with selective progesterone receptor modulators has shown promising results with shrinkage of uterine leiomyomas and a prolonged clinical effect. Selective progesterone receptor modulators provide hope for women with this challenging condition and are a promising new option in the armamentarium of medical treatments for uterine leiomyomas.
子宫平滑肌瘤自200多年前被描述以来就备受关注。这些常见的子宫良性肿瘤常表现为经期延长、盆腔压迫感和生殖功能障碍,给全球医疗保健系统带来了实实在在的经济负担。在过去几十年里,与其他治疗选择相比,子宫平滑肌瘤的手术治疗受到了最多关注。选择合适的手术技术取决于许多因素,如子宫平滑肌瘤的位置、患者年龄、对未来生育的意愿、合并症以及患者的偏好。促性腺激素释放激素激动剂和拮抗剂等药物治疗已用于有症状的子宫平滑肌瘤治疗,但仅取得部分成功。众多副作用和有限的临床效果使其不太受欢迎,并凸显了对新的有效药物治疗的迫切需求。最近,选择性孕激素受体调节剂的治疗已显示出有希望的结果,子宫平滑肌瘤缩小且临床效果持久。选择性孕激素受体调节剂为患有这种具有挑战性疾病的女性带来了希望,是子宫平滑肌瘤药物治疗手段中有前景的新选择。