The effects of RU 486 and leuprolide acetate on uterine artery blood flow in the fibroid uterus: a prospective, randomized study

Abstract

Objective: Our purpose was to examine the effects of RU 486 and leuprolide acetate on uterine artery blood flow and uterine volume.

Study design: Patients were randomly assigned to group A (eight patients) receiving 25 mg of RU 486 daily for 3 months or group B (six patients) receiving 3.75 mg of leuprolide acetate monthly for 3 months. Uterine artery blood flow change was determined by resistive index by means of vaginal color Doppler ultrasonography. Uterine volume was measured before and during the study with abdominal ultrasonography.

Results: Both groups showed an increase in resistive index. Patients receiving RU 486 had uterine artery blood flow decreased by 40%, and those receiving leuprolide acetate had a 21% decrease. We noted a significant decrease in uterine volume compared with pretreatment in both groups at 3 months. There was no significant decrease between groups.

Conclusion: Both RU 486 (25 mg daily) and leuprolide acetate (3.75 mg monthly) are effective in decreasing blood flow to the uterus (increasing resistive index) and decreasing uterine volume at 3 months. A significant decrease in uterine artery blood flow may provide a mechanism for the decrease in uterine size and the decrease in uterine blood loss at the time of surgery.

PIP: Fourteen women with uterine fibroids and scheduled to undergo either myomectomy or hysterectomy were randomly assigned to take RU-486 and leuprolide acetate over a period of three months to determine their effects upon uterine artery blood flow and uterine volume. Eight patients received 25 mg of RU-486 per day and six patients received 3.75 mg/month of leuprolide acetate over the same period. Uterine artery blood flow change was determined by resistive index by means of vaginal color Doppler ultrasonography, while uterine volume was measured before and during the study with abdominal ultrasonography. Blood flow decreased 40% among those taking RU-486 compared to 21% among those administered leuprolide acetate. Uterine volume decreased significantly for both groups without significant difference in the extent of decrease between groups. Study findings would support the hypothesis that a significant decrease in uterine artery blood flow may provide a mechanism for the decrease in uterine size and the decrease in uterine blood loss at the time of surgery.