Goserelin acetate (Zoladex) plus endometrial ablation for dysfunctional uterine bleeding: a 3-year follow-up evaluation.
OBJECTIVE
To report the results of a 3-year follow-up evaluation of a trial comparing goserelin acetate depot injections with sham injections before endometrial ablation for the treatment of dysfunctional uterine bleeding (DUB).


METHODS
Prospective, randomized, double-blind, parallel-group study.


METHODS
Thirty-seven centers in 12 countries.


METHODS
Three-hundred and fifty-eight premenopausal women aged over 30 years with DUB.


METHODS
Goserelin acetate (3.6 mg depot) every 28 days for 8 weeks, or sham depot every 28 days for 8 weeks, with endometrial ablation 6 weeks +/- 3 days after the first depot injection (i.e., when the endometrium is at its thinnest). The follow-up continued for 3 years.


METHODS
At the 3-year follow-up, bleeding in the previous 3 months and need for surgical intervention were recorded.


RESULTS
At 3 years, amenorrhea rates were 21% in the goserelin acetate group and 14% in the control group (estimated odds ratio, 1.8; 95% CI, 0.98-3.25; P=.0571). The surgical intervention rate (since the original procedure) was low and did not differ significantly between groups. For hysterectomy, it was 21% for the goserelin acetate group and 15% for the control group. For repeat ablations, it was 5.6% for the goserelin acetate group and 2.1% for the control group.


CONCLUSIONS
Prethinning with goserelin acetate before endometrial ablation resulted in higher long-term amenorrhea rates than ablation without prethinning.
Department of Gynaecology, University Hospital Saint-Luc, Brussels, Belgium.
J
J
Donnez
G
G
Vilos
M J
MJ
Gannon
R
R
Maheux
M H
MH
Emanuel
O
O
Istre
D000328:Adult; D000568:Amenorrhea; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004717:Endometrium / Q000601:surgery*; D005260:Female; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy; D016017:Odds Ratio; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
D017273:Goserelin