Randomized double-blind study evaluating the efficacy on uterine fibroids shrinkage and on intra-operative blood loss of different length of leuprolide acetate depot treatment before myomectomy.
OBJECTIVE
To determine whether length of pre-operative treatment with gonadotrophin-releasing hormone agonists (GnRHa) may have different effects on uterine shrinkage and intra-operative blood loss, 36 patients with symptomatic uterine fibroids awaiting myomectomy were randomly divided into two groups.


METHODS
Twenty patients received long-term GnRHa administration, six monthly depot injections of leuprolide acetate (LA), while 16 patients were treated with two monthly LA injections before surgery. The hemoglobin concentration and estradiol, follicle-stimulating hormone and luteinizing hormone concentrations were measured before and after treatment in both groups.


RESULTS
Uterine volume decreased in the long-term treated group from 680+/-276 cm3 to 486+/-195 cm3 (36%) after two and to 388+/-172 cm3 (51%) after six LA injections. In the short-term treated group the basal uterine volume decreased from 745+/-320 cm3 to 456+/-177 cm3 (39%) after two LA injections. The uterine volume decrease was statistically significant (p<0.05) after two LA injections in both groups while the decrease observed between two and six LA injections was not significant (p>0.05). The intra-operative blood-loss was not significantly different between the two groups studied, 315+/-93 cm3 and 336+/-88 cm3.


CONCLUSIONS
Two pre-operative GnRHa depot injections offer similar results, in terms of uterine shrinkage and intra-operative blood loss, and a longer treatment seems to be justified in cases of anemia.
Jasonni
V M
VM
Departments of Obstetrics and Gynaecology, University of Modena and Reggio Emilia, Modena, Italy.
D'Anna
R
R
Mancuso
A
A
Caruso
C
C
Corrado
F
F
Leonardi
I
I
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D004311:Double-Blind Method; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007889:Leiomyoma / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D016729:Leuprolide / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood; D009215:Myometrium / Q000187:drug effects* / Q000601:surgery*; D011300:Preoperative Care; D013997:Time Factors; D014594:Uterine Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*
D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D006454:Hemoglobins; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide