The Short-Term Use of Luteinising Hormone-Releasing Hormone Analogues in Uterine Fibroids

Spuy, Zephne van der; Fieggan, A.G.; Wood, M.J.A.; Pienaar, Cindy

doi:10.1159/000181329

Cited by 6 publications

(1 citation statement)

References 12 publications

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“…Most of this reduction occurs within the first 3 months of treatment (9). GNRH agonists have been used to facilitate surgery, particularly in preoperative management of myomectomy in infertility patients (9) and, more recently, to reduce the bulk of fibroids prior to vaginal hysterectomy (10).…”

Section: Discussionmentioning

confidence: 99%

Goserelin Reduction of Uterine Fibroids Prior to Vaginal Hysterectomy

Eizenberg¹

1995

Aust NZ J Obst Gynaeco

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EDITORIAL COMMENT: This paper is provocative and we accepted it for publication so that interested readers, as well as the editorial subcommittee, could be provoked! Our reviewer reminded us that ‘one swallow does not a summer make’ and also that the GNRH agonist did not seem to reduce the size of the fibroids greatly. Not every gynaecologist would tackle such a uterus vaginally (for what it is worth the editor certainly would not). Stovall and colleagues have reported again on the problem of having treated 90 women with uterine size of 14–18 weeks and 60 with uterine size greater than 18 weeks' gestational size. Patients in both groups were randomized to either immediate hysterectomy or 2 months of preoperative gonadotrophin‐releasing hormone agonist. The results were favourable and more or less support the views expressed in this case report. The reference is given for interested readers, but please note that vaginal hysterectomy was attempted only ‘iftheuterus wasmobileand s 14 weeks'gestational size on bimanual examination’. (Stovall TG, Sumit RL, Washburn SA, Ling FW. Gonadotrophin‐releasing hormone agonist use before hysterectomy. Am J Obstet Gynecol 1994; 170: 6: 1744–1751. Response from author to editorial comment: I am happy with your editorial comment except that the GNRH agonist did reduce the size of the fibroids by 50% (volume). If you look at the ultrasound size and convert this to volume and compare the pathology specimen, you will note that the volume has reduced from approximately 280 ml to 125 ml. This agrees with references 7 to 9 where a volume reduction of approximately 50% was obtained. Summary: A case utilising GNRH agonist to reduce the bulk of uterine fibroids to allow vaginal hysterectomy is presented.

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Section: Discussionmentioning

confidence: 99%