Gonadotropin releasing hormone agonist treatment before hysterectomy for menorrhagia and uterine leiomyomas.
OBJECTIVE
To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata-associated menorrhagia.


METHODS
Prospective, comparative, nonrandomized study.


METHODS
A teaching hospital of Milano University.


METHODS
Anemic women requiring hysterectomy for myoma-associated menorrhagia.


METHODS
Six months' preoperative goserelin treatment (41 cases) or immediate surgery (92 controls).


METHODS
Abdominal/vaginal hysterectomy rate, number of transfusions, operating time, blood loss, complications, febrile morbidity, and days in hospital.


RESULTS
In the goserelin group mean hemoglobin rose (8.5 versus 13.3 g/dl) and mean uterine volume decreased (528 versus 251 ml). At preoperative pelvic exploration abdominal hysterectomy was indicated in 22 (54%) cases and 74 (80%) controls and vaginal hysterectomy in 19 (46%) and 18 (20%) (relative risk 3.6, 95% confidence interval 1.6 to 7.7; p = 0.001). No case required a transfusion whereas 51% of controls needed a total of 127 packed red cell units.


CONCLUSIONS
In anemic women with menorrhagia and leiomyomas, gonadotropin releasing hormone agonist treatment before hysterectomy limited transfusion requirements and increased the vaginal procedure rate.
L. Mangiagalli Department of Obstetrics and Gynecology, University of Milano School of Medicine, Italy.
P
P
Vercellini
L
L
Bocciolone
A
A
Colombo
N
N
Vendola
M
M
Meschia
G
G
Bolis
D000328:Adult; D000747:Anemia, Hypochromic / Q000209:etiology; D005260:Female; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D008595:Menorrhagia / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery
D017273:Goserelin