Application of ulipristal acetate in female patients with uterine fibroids.

OBJECTIVES: Uterine fibroids are the most common benign tumors in women of reproductive age. Evidence suggest that ovarian steroid hormones, in particular, progesterone play a major role in promoting leiomyoma development and growth. For the last years there was an extensive research on selective progesterone receptor modulators and their use in therapy. Ulipristal acetate (UPA) is one of these modulators. The aim of this paper is to evaluate efficacy and safety of oral ulipristal acetate for the treatment in women with symptomatic uterine fibroids. METHODS: The study group comprised five patients with uterine fibroids. All patients received 5 mg of ulipristal acetate per day for three months. RESULTS: The total volume of fibroids decreased by 33-68%. In all patients during the administration of UPA significant reduction of menstrual bleeding was observed. Increase of endometrial thickness without clinical significance was observed in two patients. No significant side-effects were observed during the treatment period. CONCLUSIONS: 1) The volume offibroids decreased from 33 to 68%. 2) The UPA administration effectively controlled excessive bleeding. 3) Treatment with UPA may modify the scope of the surgery. 4) UPA is a well-tolerated drug.

Cancer of the urinary bladder neovagina in a patient with Morris' syndrome.

BACKGROUND: Vaginal agenesis is a rare condition, therefore the incidence of a malignant transformation in the neovagina is extremely low. CASE REPORT: We report on a 42-year-old patient with Morris' syndrome and urinary bladder neovagina with a history of prolonged infections of the urinary bladder and intertrigo of the perineal region. The biopsy revealed a squamous cell carcinoma arising from the neovagina. The patient underwent combined radio- and chemotherapy and was disqualified from surgical treatment because of the advanced stage of the disease. CONCLUSIONS: Because of the high risk of malignant transformations regular follow-ups are necessary in patients with neovagina creation, including gynecological examination, cytological screening, and biopsy if necessary. In addition, urinary bladder does not seem to be a good material for a functional vagina.

Serum lipids concentration in women with benign and malignant ovarian tumours.

UNLABELLED: Early diagnosis can improve clinical effects of ovarian carcinoma treatment. Until now, a satisfying screening method has not been found. Serum lipid and lipoprotein association with neoplasm is already established. In our study, we have examined concentration of total cholesterol, free cholesterol, HDL cholesterol, HDL3 and HDL free cholesterol fraction, triglycerides, and apolipoproteins: AI, AII and B and aimed to prepare the most likely model of lipid profile in women suffering from ovarian neoplasm. The serum lipid parameters were analysed in 91 operated patients: 64 with ovarian malignant tumour, 27 with benign ovarian cysts and 44 apparently healthy age-matching pair women as a control group. THE RESULTS: concentration of two parameters: apolipoprotein AI and free cholesterol allows for excluding ovarian neoplasm in 95.5%; examination of six parameters: apolipoprotein AI, free cholesterol, HDL-free cholesterol, HDL total cholesterol, apolipoprotein B and HDL3 fraction allows for diagnosing ovarian malignancy with 97% probability. This probability does not depend on staging of cancer, patient's age, nor BMI. No statistically significant difference between malignant and benign ovarian tumour has been confirmed.