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Clinical and experimental particularities of regional blood flow disorders in symptomatic uterine myoma


Author: Corina Cardaniuc
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2005
Scientific adviser: Valentin Friptu
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Mihail Todiraş
doctor habilitat, associate professor (docent), State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 15 February, 2005
Approved by NCAA on the 21 April, 2005

Abstract

Adobe PDF document0.23 Mb / in romanian

Thesis

CZU 618.14-006.36-08:618.14-005.1+615.711.7+616.13

Adobe PDF document 1.98 Mb / in romanian
132 pages


Keywords

uterine myoma, uterine artery, uterine bleeding, blood flow, vascular reactivity, Izoturon

Summary

The lack of a single opinion about the pathogenesis of uterine myoma significantly reduces the treatment effectiveness and dictates the necessity of further researches on the mechanisms, pathogenesis chains and particularities of tumor evolution, the search to detect new possibilities of diagnosis and ways to increase the effectiveness of therapy.

The present study was conducted to assess regional blood flow changes in patients with symptomatic uterine myoma in dependence on tumor size and the presence of abnormal uterine bleeding. The obtained result demonstrated an enhancement of local uterine haemodinamics and an augmentation of uterine arterial blood flow in pacients with symptomatic uterine myoma. We noticed a progressive decrease of uterine arterial Doppler indicies with increasing tumor size.

Our histological and morphometric findings demonstrated the increase in thickness in all layers of uterine artery wall in uterine myoma, and there was a correlation between the degree of thickening and myoma size.

Organ bath experiments showed that contractile reactivity in vitro of uterine artery to adrenergic, serotoninergic and angiotensinic stimulation diminishes with myoma growth and the cholinergic vasorelaxation increases. This changes are stronger in myoma associated with abnormal uterine bleeding. At the same time, our experimenthal data demonstrated that Izoturon, a specific nitric oxide synthase inhibitor, stimulates the adrenergic, serotoninergic and angiotensinic vasoconstriction of uterine arteries and significantly reduces the vasodilator effect of acetylcholine.

On the basis of our results was elaborated a new method using for the first time the medicine Izoturon (vaginal suppositories) in the treatment of abnormal uterine bleedings and pelvic pain associated with uterine myoma. Our rezults showed that Izoturon 100 mg.(vaginal suppozitories) is an eficient medicine with disappearance of uterine bleeding in 87,8% cases and disappearance of pelvic pain in 100% cases.

The established benefits of the medicine Izoturon offer a new strategie for therapeutic intervention in patients with symptomatic uterine myoma.