The place of GnRH agonists in the treatment of endometriosis and fibroids by advanced endoscopic techniques

Donnez, Jacques; Nisolle, Michelle; Grandjean, Pascale; Gillerot, Stéphane; Clerckx, Françoise

doi:10.1111/j.1471-0528.1992.tb13537.x

Cited by 35 publications

(12 citation statements)

References 13 publications

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“…Prior treatment with a GnRH‐agonist may enable more hysterectomies to be performed vaginally (Stovall et al 1991) with reduced morbidity and no abdominal scar (Dicker et al 1982), or they may facilitate removal of the uterus by laparoscopically assisted vaginal hysterectomy (Nezhat et al 1992). Another option may be that the fibroids can be removed by myomectomy rather than hysterectomy (Donnez et al 1992). A more conservative approach may mean a shorter hospital stay and better, faster patient recovery.…”

Section: Discussionmentioning

confidence: 99%

Treatment with the gonadotrophin releasing hormone‐agonist goserelin before hysterectomy for uterine fibroids

Lumsden

West

Thomas

et al. 1994

BJOG

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Objective To investigate the effect of the gonadotrophin releasing hormone (GnRH)-agonist goserelin, given by monthly subcutaneous injection for three months prior to total abdominal hysterectomy for uterine leiomyomata, on the pre-operative symptoms, difficulty of operation and operative blood loss.Design Randomised placebo-controlled study.Setting Patients were recruited from the gynaecological outpatient departments from hospitals in Edinburgh, Glasgow and Newcastle.Subjects Seventy-one premenopausal women with uterine leiomyomata who were on the waiting list for hysterectomy. InterventionsAfter the presence of leiomyomata was confirmed using ultrasonography, the women were randomised to receive either the GnRH-agonist goserelin by monthly subcutaneous injection or a sham injection for three months prior to operation. At the monthly visits, patients were asked about treatment related symptoms, fibroid related symptoms, and their bleeding patterns. Blood was taken for haematological assessment. Main outcome measuresHaemoglobin concentrations at recruitment, at operation and postoperatively, pre-operative symptoms, operative difficulty and blood loss and post-operative complications.Results Treatment with goserelin induced amenorrhoea in over 80 YO of the women, and this was associated with a significant rise in haemoglobin level. At the time of operation, fibroid related symptoms were less in the goserelin group than in the placebo group. The hysterectomy was technically easier and the median (range) operative blood loss was significantly lower in the goserelin group compared with the placebo group (187 (60-600) ml vs 308 (I 18-1000) ml respectively; P < 0.05, Wilcoxon signed rank test). There was no difference between the two groups in the duration of hospital stay or the frequency of post-operative complications. The fibroids were smaller at the time of operation in the goserelin group, and more women treated with goserelin were able to have their operations through a transverse incision. ConclusionsThis study demonstrates the benefits of goserelin in women having total abdominal hysterectomy for uterine leiomyomata.

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Section: Discussionmentioning

confidence: 99%

Treatment with the gonadotrophin releasing hormone‐agonist goserelin before hysterectomy for uterine fibroids

Lumsden

West

Thomas

et al. 1994

BJOG

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“…Candiani et al 5 demonstrated clearly the advantages of pretreatment in severely anaemic women. The reduction of uterine size may also enable hysterectomy via the vaginal route 15 rather than abdominally, or may allow endoscopic surgery 6 .…”

Section: Discussionmentioning

confidence: 99%

Deferred versus immediate surgery for uterine fibroids: clinical trial results

Audebert¹,

Madenelat

Querleu

et al. 1994

BJOG

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“…Previous studies described a significant size reduction of fibroids after only 6-8 weeks of treatment (28,29).…”

Section: Gnrh Agonistmentioning

confidence: 98%

Techniques to reduce blood loss during open myomectomy: a qualitative review of literature

Conforti

Mollo

Tsimpanakos

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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The place of GnRH agonists in the treatment of endometriosis and fibroids by advanced endoscopic techniques

Cited by 35 publications

References 13 publications

Treatment with the gonadotrophin releasing hormone‐agonist goserelin before hysterectomy for uterine fibroids

Treatment with the gonadotrophin releasing hormone‐agonist goserelin before hysterectomy for uterine fibroids

Deferred versus immediate surgery for uterine fibroids: clinical trial results

Techniques to reduce blood loss during open myomectomy: a qualitative review of literature

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