GnRH analogue treatment before hysteroscopic resection of submucous myomas: a prospective, randomized, multicenter study.
OBJECTIVE
To evaluate the efficacy of GnRH analogue treatment before hysteroscopic resection of submucous myomas in patients with abnormal uterine bleeding.


METHODS
Multicenter, prospective, randomized, clinical study.


METHODS
Tertiary-care university hospitals.


METHODS
Thirty-nine consecutive patients with submucous myomas graded as G0 or G1 according to the European Society for Gynecological Endoscopy classification (myoma size 10-35 mm).


METHODS
Patients were randomized to either direct surgery or 2 months of GnRH analogues before undergoing hysteroscopic resection of the submucous myoma.


METHODS
Operating times, fluid absorption, difficulty of the operation, surgeon satisfaction with the procedure, intra- and postoperative complications, postoperative pain, and patient satisfaction were recorded.


RESULTS
Patients treated with GnRH analogue had significantly shorter operative times (15.9+/-3.1 minutes vs. 21.3+/-4.0 minutes) and significantly reduced fluid absorption (378+/-137 mL vs. 566+/-199 mL) compared with no preoperative medical treatment. Operative difficulty and overall surgeon satisfaction were significantly better in the GnRH analogue group. Patient satisfaction was similar in the two groups.


CONCLUSIONS
GnRH analogue treatment before hysteroscopic resection of G0-G1 10-35 mm submucous myomas was effective in reducing operative times, fluid absorption, and difficulty of the procedure.
Muzii
Ludovico
L
Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy. Electronic address: l.muzii@unicampus.it.
Boni
Terenzio
T
Department of Obstetrics and Gynecology, "Sapienza" University, Rome, Italy.
Bellati
Filippo
F
Department of Obstetrics and Gynecology, "Sapienza" University, Rome, Italy.
Marana
Riccardo
R
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart and International Scientific Institute "Paolo VI," Rome, Italy.
Ruggiero
Alfonso
A
Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy.
Zullo
Marzio A
MA
Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy.
Angioli
Roberto
R
Department of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy.
Panici
Pierluigi Benedetti
PB
Department of Obstetrics and Gynecology, "Sapienza" University, Rome, Italy.
D000328:Adult; D000465:Algorithms; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008186:Luteolytic Agents / Q000008:administration & dosage; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000453:epidemiology; D017329:Triptorelin Pamoate / Q000008:administration & dosage*; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
D018931:Antineoplastic Agents, Hormonal; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone