Does Preoperative Treatment with a Gonadotropin-Releasing Hormone Agonist Improve the Outcome of Endometrial Resection?

Paolo Vercellini, Antonio Perino, Roberto Consonni, Sabina Oldani, Fabio Parazzini, Pier Giorgio Crosignani

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Abstract

Study Objective. To verify if more favorable long-term results of endometrial resection can be obtained with pre- operative 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.

Original languageEnglish
Pages (from-to)357-360
Number of pages4
JournalAmerican Association of Gynecologic Laparoscopists
Volume5
Issue number4
Publication statusPublished - 1998

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Gonadotropin-Releasing Hormone
Goserelin
Hemorrhage
Menorrhagia
Amenorrhea
Advisory Committees
Tertiary Healthcare
Therapeutics
Randomized Controlled Trials

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Does Preoperative Treatment with a Gonadotropin-Releasing Hormone Agonist Improve the Outcome of Endometrial Resection? / Vercellini, Paolo; Perino, Antonio; Consonni, Roberto; Oldani, Sabina; Parazzini, Fabio; Crosignani, Pier Giorgio.

In: American Association of Gynecologic Laparoscopists, Vol. 5, No. 4, 1998, p. 357-360.

Research output: Contribution to journalArticle

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abstract = "Study Objective. To verify if more favorable long-term results of endometrial resection can be obtained with pre- operative 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.",
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