Gonadotropin-releasing hormone agonist treatment before abdominal myomectomy: a controlled trial.
OBJECTIVE
To ascertain whether adjuvant gonadotropin-releasing hormone (GnRH) agonist therapy decreases blood loss during abdominal myomectomy.


METHODS
Randomized controlled trial.


METHODS
Academic reproductive surgery center.


METHODS
One hundred premenopausal women requiring first-line conservative surgery for symptomatic intramural or subserous fibroids.


METHODS
Eight weeks of treatment with depot triptorelin before myomectomy or immediate surgery.


METHODS
Intraoperative blood loss, operating time, degree of difficulty of the procedure, and short-term rate of fibroid recurrence.


RESULTS
Mean (+/-SD) intraoperative blood loss was 265 +/- 181 mL in triptorelin recipients and 296 +/- 204 in patients who had immediate surgery (mean difference, -31 mL [95% CI, -108 to 46 mL]). No significant differences were observed in blood loss according to uterine volume, number of fibroids removed, or total length of myometrial incisions. Most procedures in either group were of routine difficulty. On ultrasonography 6 months after myomectomy, four women in the GnRH agonist group and one in the immediate surgery group had tumor recurrence.


CONCLUSIONS
Treatment with a GnRH agonist before abdominal myomectomy has no significant effect on intraoperative blood loss. Thus, systematic use of medical therapy before abdominal myomectomy does not seem to be justified.
Vercellini
Paolo
P
Clinica Ostetrica e Ginecologica I, Istituto Luigi Mangiagalli, University of Milan, Milan, Italy. paolo.vercellini.@unimi.it
Trespìdi
Laura
L
Zaina
Barbara
B
Vicentini
Sarah
S
Stellato
Giovanna
G
Crosignani
Pier Giorgio
PG
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy / Q000601:surgery*; D017329:Triptorelin Pamoate / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000601:surgery*
D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D017329:Triptorelin Pamoate