title: The degree of fluid absorption during hysteroscopic surgery in patients pretreated with goserelin.
abstract: OBJECTIVE
  To assess the effects of pretreatment with the gonadotropin-releasing hormone analog goserelin on fluid absorption in patients undergoing hysteroscopic endometrial ablation.
  
  
  METHODS
  Prospective, randomized, placebo-controlled study.
  
  
  METHODS
  A university-based clinic.
  
  
  METHODS
  Thirteen women with dysfunctional uterine bleeding who were scheduled for electrosurgical hysteroscopic ablation.
  
  
  METHODS
  Seven women were randomized to receive luteal phase goserelin 3.75 mg and six saline in the menstrual cycle approximately 10 weeks before surgery. Operative hysteroscopy was carried out with glycine 1.5% mixed with 2% alcohol medium under constant pressure as an irrigant. The amount of irrigant used, irrigant deficit, blood levels of albumin and ethanol, hematocrit, hemoglobin, changes in sodium levels, and central venous pressure were compared between the groups.
  
  
  RESULTS
  All of the patients had an unsuccessful course of medical therapy for at least 3 months and a normal endometrial biopsy. The age, weight, and uterine size were similar between the groups. The mean volume of irrigant used and operating time were similar in both groups (4.18 +/- 0.2 vs 4.5 +/- 0.5 L, and 33.7 +/- 1.5 vs 37 +/- 2.1 min). Although operating time, volume deficit, decrease in protein level, and hematocrit were less in the goserelin than in the saline group, the differences were not statistically significant (p >0.05). The ethanol levels in blood, decrease in Na+, and irrigant deficit were significantly lower in the goserelin than in the saline group (17.4 +/- 3.8 vs 25.3 +/- 4.2 mg/ml, 6.7 +/- 1.2 vs 9.1 +/- 0.9 mEq/L, and 0.49 +/- 0.08 vs 0.66 +/- 0.05 L, respectively; p <0.05).
  
  
  CONCLUSIONS
  Based on these results we conclude that in women undergoing hysteroscopic endometrial ablation, pretreatment with goserelin may decrease the absorption of hysteroscopic medium, prevent fluid overload, and improve the outcome possibly by causing hypovascularity and decreased endometrial growth.
authors.affiliation: Department of Obstetrics and Gynecology, Inonu University Medical School, Malatya, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Taskin
authors.forename: A
authors.initials: A
authors.lastname: Yalcinoglu
authors.forename: S
authors.initials: S
authors.lastname: Kucuk
authors.forename: F
authors.initials: F
authors.lastname: Burak
authors.forename: U
authors.initials: U
authors.lastname: Ozekici
authors.forename: J M
authors.initials: JM
authors.lastname: Wheeler
mesh_terms: D000042:Absorption; D000328:Adult; D004598:Electrosurgery; D004717:Endometrium / Q000473:pathology / Q000601:surgery*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000819:agonists*; D017273:Goserelin / Q000008:administration & dosage*; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D012996:Solutions / Q000493:pharmacokinetics; D007507:Therapeutic Irrigation; D014592:Uterine Hemorrhage / Q000378:metabolism / Q000473:pathology / Q000601:surgery*
chemical_list: D012996:Solutions; D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone