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To investigate tolerability and efficacy of nomegestrol acetate, a new 19-nor-progesterone derivative, in the treatment of oligomenorrhea and amenorrhea; to compare this drug with didrogesteron, a widely-used spatial isomer of progesterone.56 women, aged 22 to 50, affected by menstrual disorders or premenstrual syndrome, entered the study. They were divided in two homogeneous groups by randomization. In the first group nomegestrol acetate was administered 5 mg daily per os; in the second group patients were treated by the usual didrogesteron dose, that is 10 mg twice a day per os; both treatments were administered for 10 days from day 16, during three consecutive menstrual cycles. Efficacy, compliance and biological tolerance were evaluated.24 patients in the group treated by nomegestrol acetate and 22 in the group treated by didrogesteron completed the study. After the first cycle of therapy, nomegestrol acetate showed a higher efficacy in reducing menstrual loss; results are statistically homogeneous in the two groups at the end of the study. There were no reports of pain in both the groups. Evaluation of biological and clinical parameters at the end of the study did not show significant modifications in any subject.Nomegestrol acetate is an innovative and efficient molecule in the treatment of menstrual disorders. A good response to the drug is evident in a short time and with very low doses; its good compliance, if compared with other progesteron-derivatives, indicates nomegestrol acetate as a first-line therapy for polymenorrhea, olygomenorrhea and premenstrual syndrome.

To evaluate the use of UGP (urinary gonadotropin protein) as a tumor marker in gynaecologic and obstetric malignant diseases.The study was carried out in the division of Gynaecology and Obstetrics of the Ospedali Riuniti in Bergamo. 63 patients, with obstetric or gynaecologic benign or malignant diseases, entered the study. 66 healthy volunteers were examined as a group-control. In both the groups UGP levels were determined in morning urine, using an immunoenzymatic commercial kit.Results, expressed in fmol UGP/ml of urin, show that UGP is produced by several neoplasms, but the false-positive percentage is still high; a higher precision can be obtained with an accurate choice of the cut-off value and with a standardization of the analytical technics. Besides, the contemporary determination of UGP and CA 125 levels reduces the possibility of false-positive and false-negative results.More studies must be carried out to confirm the value of UGP as a tumor marker in obstetrics and gynaecology. Anyway, this recently purified protein can already be useful, in combination with the usual tumor markers, in the prompt diagnosis and management of primary neoplasms or recurrences, with a higher sensibility in comparison with traditional clinical and radiological examinations.

A national multicentre trial was organized in order to compare the efficacy and safety of leuprorelin acetate depot and danazol in the treatment of endometriosis. Sixty-seven patients with pelvic endometriosis of different severity at laparoscopy were included in the study and followed during the 24 weeks of treatment. Leuprorelin acetate depot 3.75 mg was injected every 24 days, while the daily dose of danazol was 600-800 mg. At the end of the study objective improvements induced by the two drugs were observed by a second laparoscopic examination. In addition, at regular intervals during the study semiquantitative evaluation of subjective symptoms were monitored. Scoring the final objective changes in the two patient groups revealed no significant difference, however the women treated with leuprorelin acetate depot registered significantly better control of pelvic pain. Due to its efficacy, tolerability and ease of use, leuprorelin acetate appears to be an excellent drug for the treatment of endometriosis.

Six cases of pelvic exenteration, performed between 1 January 1987 and 30 June 1989 in the Obstetric-Gynecological Division of the Ospedali Riuniti of Bergamo are reported. Indications, surgical methods and complications are analysed in comparison to published data. From an analysis of our data it may also be concluded that pelvic exenteration has a role in the treatment of persistent and recurrent gynecological tumors, provided that patients are carefully selected.