title: Gonadotropin-releasing hormone agonist treatment before abdominal myomectomy: a controlled trial.
abstract: 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.
authors.affiliation: Clinica Ostetrica e Ginecologica I, Istituto Luigi Mangiagalli, University of Milan, Milan, Italy. paolo.vercellini.@unimi.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Vercellini
authors.forename: Laura
authors.initials: L
authors.lastname: Trespìdi
authors.forename: Barbara
authors.initials: B
authors.lastname: Zaina
authors.forename: Sarah
authors.initials: S
authors.lastname: Vicentini
authors.forename: Giovanna
authors.initials: G
authors.lastname: Stellato
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Crosignani
mesh_terms: 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*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D017329:Triptorelin Pamoate