Hysteroscopic Myomectomy: Is There a Place for Pretreatment with GnRH Agonist?

Abstract

Uterine fibroids (also known as myomas or leiomyomas) are the commonest benign solid tumours found in the female genital tract. Hysteroscopic myomectomy presently represents the standard minimally invasive surgical procedure for treating submucous fibroids. Whether treatment with GnRH agonist before hysteroscopic myomectomy offers significant advantages is still a matter of debate.A literature search was performed using Medline and the Google search engine, Springerlink and Highwire Press. A total of 11 articles were selected for review.GnRH agonist use prior to hysteroscopic myomectomy probably has potential benefits in terms of reduction in size of the fibroid and improvement of hemoglobin level, especially in patients with underlying secondary anemia. However, universally acceptable guidelines on the indications and duration of pretreatment whether administered monthly or as daily injections are lacking. Large randomized controlled trials are urgently needed to clarify the gray areas.