Document Detail


Does preoperative treatment with a gonadotropin-releasing hormone agonist improve the outcome of endometrial resection?
MedLine Citation:
PMID:  9782138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To verify if more favorable long-term results of endometrial resection can be obtained with preoperative gonadotropin-releasing hormone (GnRH) agonist treatment. DESIGN: Multicenter, randomized, controlled trial (Canadian Task Force classification I). SETTING: Tertiary care academic department. PATIENTS: Sixty-three premenopausal women with established menorrhagia. INTERVENTION: Eight weeks of goserelin depot treatment before endometrial resection or immediate surgery in the early proliferative phase of the cycle. MEASUREMENTS AND MAIN RESULTS: Variations in menstrual patterns and bleeding scores as well as overall degree of satisfaction with treatment were determined 1 year after endometrial resection. Mean +/- SD monthly pictorial blood loss-assessment chart scores in the second 6-month follow-up period were 26.9 +/- 31.6 in the goserelin group and 44.0 +/- 45.7 in the immediate surgery group (mean difference 17.1 points, 95% CI -3.0 to +37.2, p = 0.09, unpaired t test). Respective amenorrhea rates were 34% (11/32) and 20% (6/20, p = 0.26, Fisher's exact test, 95% CI of difference -8% to +37%). Overall satisfaction with treatment was 91% and 87%, respectively. CONCLUSION: Administration of a GnRH agonist before endometrial resection is advantageous for surgery, but has a limited effect in terms of postoperative bleeding pattern and appears not to offer clear-cut long-term clinical benefit.
Authors:
P Vercellin; A Perin; R Consonn; S Oldan; F Parazzini; P G Crosignani
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of the American Association of Gynecologic Laparoscopists     Volume:  5     ISSN:  1074-3804     ISO Abbreviation:  J Am Assoc Gynecol Laparosc     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-01-29     Completed Date:  1999-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9417443     Medline TA:  J Am Assoc Gynecol Laparosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  357-60     Citation Subset:  IM    
Affiliation:
Clinica Ostetrica e Ginecologica "Luigi Mangiagalli," Universita di Milano, Via Commenda, 12, 20122 Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adenomyoma / complications,  surgery
Adult
Antineoplastic Agents, Hormonal / administration & dosage,  therapeutic use*
Delayed-Action Preparations
Electrocoagulation* / methods
Endometrium / surgery*
Endoscopy*
Female
Goserelin / administration & dosage,  therapeutic use*
Humans
Menorrhagia / drug therapy,  etiology,  surgery*
Middle Aged
Preoperative Care
Prospective Studies
Treatment Outcome
Uterine Neoplasms / complications,  surgery
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 0/Delayed-Action Preparations; 65807-02-5/Goserelin

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