[A comparative efficacy study of the preoperative use of GnRH agonists in women with uterine fibromyomas]

Abstract

The aim of the study is to establish the efficacy of preoperative use of GnRH agonists in women with uterine fibromyomas. The study is a randomized prospective one and includes 34 patients, divided in two groups: group I--with preoperative application of GnRH agonists--Zoladex and group II--without medication. In Zoladex group amenorrhea was achieved in 76% of patients after 7-8 weeks of treatment. After a 3-months treatment with Zoladex Hb levels increased from 8.9 +/- 0.9 gl/l to 11.7 +/- 1.2 g/l; levels of serum Fe--from 7.3 +/- 4 mumol/l to 18.5 +/- 5 mumol/l. Total uterine volume decreased by 30% before surgery (from 328 +/- 85 ml to 233 +/- 61 ml), while myoma volume decreased by 39% (from 178 +/- 62 ml to 109 +/- 44 ml). Mean blood loss during surgery (hysterectomy) is definitely less in patients, treated with Zoladex--194 +/- 75 ml., compared to 287 +/- 102 ml in control group. The significant reduction in myoma volume in 6 patients due to presurgical treatment with Zoladex made smaller operation--myomectomy, possible. Side effects, related to GnRH agonist Zoladex, are well tolerated and transitory and did not lead to retreatment from the trial.