Short term treatment with leuprolide acetate is a successful adjunct to surgical therapy of leiomyomas of the uterus.
Gonadotropin releasing hormone analogs (GnRHa) have been used to induce a reduction in the size of leiomyomas of the uterus after three to six months of therapy. However, none of the studies have noted a significant decrease in size by the first month. Additionally, the results of two reports have suggested long term therapy with GnRHa induced significant aberrations of serum lipoproteins. To evaluate whether or not analog treatment for a short course (two months) would be efficacious, 27 patients with leiomyomas documented by examination of the pelvic area and vaginal ultrasound, who desired to preserve reproductive potential, had myomectomies two and one-half months after commencing depot leuprolide acetate therapy. The reduction in size of the uterus was 35 percent by the first month and the average reduction in the total volume was 44 percent after two months of treatment (474 +/- 364 to 265 +/- 173 milliliters; p less than 0.01). Furthermore, the size of the uterus, determined by examination, decreased significantly from 13.6 +/- 4.0 weeks initially to 10.1 +/- 3.0 weeks preoperatively (p less than 0.0001). Estradiol levels became menopausal by one month of therapy and remained suppressed preoperatively. Menopausal symptoms were well tolerated. Cholesterol, high density lipoprotein, extremely low density lipoprotein and triglyceride levels were not altered by analog treatment, although low density lipoprotein increased from 117 to 130 milligrams per deciliter. A short course of depot leuprolide acetate reduced the size of leiomyomas and surgical tissue planes were preserved, facilitating removal of leiomyomas, and furthermore, there was no significant clinical alteration in lipoprotein or triglyceride levels.
Coddington
C C
CC
Department of Obstetrics and Gynecology, United States Naval Hospital, Portsmouth, Virginia.
Brzyski
R
R
Hansen
K A
KA
Corley
D R
DR
McIntyre-Seltman
K
K
Jones
H W
HW
D000328:Adult; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D008074:Lipoproteins / Q000187:drug effects; D014280:Triglycerides / Q000378:metabolism; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery
D008074:Lipoproteins; D014280:Triglycerides; D016729:Leuprolide