title: Ulipristal Acetate Before High Complexity Hysteroscopic Myomectomy: A Retrospective Comparative Study.
abstract: OBJECTIVE
  To evaluate the efficacy of preoperative treatment with ulipristal acetate (UPA) in patients undergoing high complexity hysteroscopic myomectomy.
  
  
  METHODS
  Retrospective analysis of a prospectively collected database (Canadian Task Force classification II-2).
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Patients of reproductive age requiring hysteroscopic myomectomy with STEPW (size, topography, extension, penetration, and wall) score 5 or 6.
  
  
  METHODS
  Patients included in the study either underwent direct surgery (group S) or received a 3-month preoperative treatment with UPA (group UPA). Based on a power calculation, 25 patients were required in each study group.
  
  
  RESULTS
  Myoma characteristics were similar in the 2 study groups. The 3-month UPA treatment caused a 21.9% (±10.3%) mean (±SD) percentage decrease in myoma volume. The number of complete resections (primary outcome of the study) was higher in group UPA (92.0%) than in group S (68.0%; p = .034). The operative time was lower in group UPA than in group S (p = .048), whereas there was no significant difference in fluid balance between the 2 study groups (p = .256). The incidence of complications was similar in the 2 groups (p = .609). Patient satisfaction at 3 months from surgery was higher in group UPA than in group S (p = .041).
  
  
  CONCLUSIONS
  A 3-month preoperative treatment with UPA increases the possibility of complete resection in high complexity hysteroscopic myomectomy. It decreases the operative time and improves patient satisfaction at 3 months from surgery.
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy. Electronic address: simone.ferrero@unige.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Racca
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Tafi
authors.affiliation: Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Alessandri
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Venturini
authors.affiliation: Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Leone Roberti Maggiore
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007889:Leiomyoma / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D009649:Norpregnadienes / Q000008:administration & dosage*; D061646:Operative Time; D017060:Patient Satisfaction; D011300:Preoperative Care; D011980:Receptors, Progesterone / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods; D014594:Uterine Neoplasms / Q000150:complications / Q000188:drug therapy / Q000601:surgery*
chemical_list: D009649:Norpregnadienes; D011980:Receptors, Progesterone; C555622:ulipristal acetate
keywords: Hysteroscopy; Myomectomy; Resection; Ulipristal acetate; Uterine myoma