title: Risk of recurrent menorrhagia after hydrothermoablation: role of GnRH analogues neoadjuvant treatment in long-term successful rate.
abstract: OBJECTIVE
  To evaluate the long-term effectiveness of presurgical therapy with GnRH analogues in patients who underwenthydrothermal endometrial ablation (HTA) for menorrhagia and assess the relationship between sonographically measured myometrium thickness and pelvic pain.
  
  
  METHODS
  A prospective randomized control study comparing 15 women (Group A) with presurgical subcutaneous triptorelin depot injection before HTA with controls (Group B, n = 15). Inclusion criteria were: recurrent menorrhagia, uterus length < 12 cm, no previous hormonal therapy for at least six month, and family plan completed. Student's t test was applied, as appropriate, to compare continuous variables. Proportion were compared with chi-squared.
  
  
  RESULTS
  After 12 months of follow-up, Group A showed a significantly lower (0% vs 20%; p = 0.03) failure rate after hydrothermoablation than the Group B and a generally higher successful rate at 24 and 48 months. The discomfort, evaluated with VAS, showed a mean value of 47.6 +/- 15.9 +/- SD); 96.7% of women reported a mild-moderate postoperative pain. No perioperative and late complications were recorded.
  
  
  CONCLUSIONS
  Presurgical treatment with GnRH analogues seems to improve long-term efficacy of HTA. Perioperative pelvic pain seems to not be affected by myometrium thickness.
authors.forename: P
authors.initials: P
authors.lastname: Litta
authors.forename: C
authors.initials: C
authors.lastname: Saccardi
authors.forename: L
authors.initials: L
authors.lastname: Tommasi
authors.forename: J
authors.initials: J
authors.lastname: Di Giuseppe
authors.forename: G
authors.initials: G
authors.lastname: Delli Carpini
authors.forename: A
authors.initials: A
authors.lastname: Ciavattini
mesh_terms: D000328:Adult; D017024:Chemotherapy, Adjuvant; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D055356:Endometrial Ablation Techniques / Q000379:methods*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D015907:Hysteroscopy; D008186:Luteolytic Agents / Q000008:administration & dosage*; D008595:Menorrhagia / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010147:Pain Measurement; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage*; D014599:Uterus / Q000473:pathology
chemical_list: D003692:Delayed-Action Preparations; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone