Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran.
Endometriosis Research Center (Drs. Vahdat and Mansouri); Iran University of Medical Sciences, Tehran, Iran , (Dr. Kashanian); Department of Radiology, School of Medicine (Dr. Mostafavi), Iran University of Medical Sciences, Tehran; Department of Gynecology (Dr. Mansouri); HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Future Studies in Health (Mr. Mirzaei and Dr. Shahesmaeili), Kerman University of Medical Sciences, Kerman, Iran.
J Minim Invasive Gynecol. 2020 May-Jun;27(4):826-831. doi: 10.1016/j.jmig.2019.05.026. Epub 2020 Feb 24.
To assess the efficacy of prostaglandin F2α (PGF) in hysteroscopic myomectomy of submucous myomas.
Single-blind, randomized clinical trial study.
Teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran.
Forty-four patients with symptomatic submucous myomas were randomly assigned to the intervention group (n = 21; 1 excluded owing to myoma not identified on pathologic examination) and the control group (n = 22).
In the intervention group, PGF was injected into the cervix twice: before the beginning of the surgery and after the resection of the intrauterine portion of the submucous myoma. TIn the control group, the myomas were resected without the PGF injection. The same procedure was performed in the control group without the PGF injection.
There were no differences in the demographics, size, or type of myomas among the groups at baseline. Although the proportion of complete removal of the submucous myomas in the intervention group (PGF) was higher (20/23 myomas or 87%) than that in the control group (15/23 myomas or 65.2%), the difference was not significant (p = .1). The number of 1-step complete removal of large submucous myomas (>5 cm) in the PGF group was significantly higher than that in the control group (8/10 myomas [80%] vs 2/8 myomas [25%], p = .03). The mean duration of operative time was significantly longer in the intervention group than in the control group (p = .01). The intervention group experienced more days of postoperative bleeding than the control group (p = .001). There were no differences regarding the length of stay at the hospital or hemoglobin levels between the groups (p = .07).
In the current study, injection of PGF was beneficial for 1-step complete resection of large (>5 cm) submucous myomas via hysteroscopic myomectomy.
评估前列腺素 F2α（PGF）在宫腔镜下黏膜下肌瘤切除术治疗黏膜下肌瘤中的疗效。
单盲、随机临床试验研究。
伊朗德黑兰医科大学附属医院教学医院。
44 例有症状的黏膜下肌瘤患者被随机分配到干预组（n=21；1 例因病理检查未发现肌瘤而排除）和对照组（n=22）。
干预组在宫颈内两次注射 PGF：手术开始前和切除黏膜下肌瘤的宫腔内部分后。对照组未注射 PGF 切除肌瘤。对照组在不注射 PGF 的情况下进行相同的手术。
基线时，两组患者的人口统计学、肌瘤大小或类型无差异。尽管干预组（PGF）完全切除黏膜下肌瘤的比例（23 个肌瘤中的 20 个或 87%）高于对照组（23 个肌瘤中的 15 个或 65.2%），但差异无统计学意义（p=0.1）。PGF 组完全切除 1 个大黏膜下肌瘤（>5 cm）的数量明显多于对照组（10 个肌瘤中的 8 个[80%]与 8 个肌瘤中的 2 个[25%]，p=0.03）。干预组的手术时间明显长于对照组（p=0.01）。干预组术后出血天数多于对照组（p=0.001）。两组住院时间和血红蛋白水平无差异（p=0.07）。
在本研究中，在宫腔镜下子宫肌瘤切除术治疗大（>5 cm）黏膜下肌瘤时，注射 PGF 有利于 1 步完全切除。
