Relugolix combination therapy and symptoms of uterine myomatosis. Selected case reports of indication spectrum and treatment outcomes.

Authors

  • Robert Hudeček Gynekologicko - porodnická klinika FN Brno a LF MU
  • Soňa Šimová FN Brno https://orcid.org/0009-0005-0058-2252
  • Jaroslav Klát Gynekologicko - porodnická klinika FN Ostrava, Ostrava
  • Karel Pohl Gynekologická ambulance GYNPOHL s.r.o., Poliklinika ALTES, Kralupy n. Vltavou
  • Aleš Prokopenko Soukromá gynekologicko – porodnická ordinace HEBEMED, Praha
  • Lubomír Mikulášek Centrum Minimálně Invazivní Gynekologické Operativy (CMIGO), Reprodukční Medicíny (CRM), Endometriosy, Adenomyosy (CLEA) & Centrum Léčby Myomů (CLM), Praha
  • Petr Krčál Gynekologie MUDr. Krčál, s.r.o., Gynekologická ordinace – Chlumčany, Chotěšov
  • Aleš Ševčík Gynekologická ambulance, Jihlava
  • Pavel Tomeš Ambulance pro léčbu myomatózy a endometriózy FN Plzeň, Plzeň

Keywords:

relugolix combination therapy – uterine fibroid symptoms

Abstract

Summary

 

Aim: An illustrative review of the indications for Relugolix combination therapy (RCT) in the management of symptoms associated with uterine myomatosis.

Methods: a collection 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 a 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 diffuse 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 optimization and greater effectiveness of therapeutic procedures and increased quality of life for women with myomatosis.

Keywords: Relugolix combination therapy; uterine fibroid symptoms;

Published

2023-10-30

Issue

Section

Gynecology and Obstetrics

Categories