Three-month treatment with triptorelin, letrozole and ulipristal acetate before hysteroscopic resection of uterine myomas: prospective comparative pilot study

Abstract Objective To compare the usefulness of preoperative treatment with triptorelin, letrozole or ulipristal acetate or no treatment before hysteroscopic removal of uterine submucosal myomas. Study design Single center prospective non-randomized comparative pilot study. The study included consecutive premenopausal patients undergoing hysteroscopic resection of myomas graded as type 0, type 1 or type 2 according to the FIGO classification with diameter between 20 and 35 mm. Exclusion criteria were: associated polyps, associated non-hysteroscopic surgical procedures, >2 myomas requiring hysteroscopic resection. This study enrolled patients who underwent either direct surgery (group S; n = 23) or 3-month preoperative treatment with triptorelin (3.75 mg every 28 days; group T; n = 20), letrozole (2.5 mg/day; group L; n = 11) or ulipristal acetate (5 mg/day; group U; n = 7). Patients underwent hysteroscopic resection of the myomas. Results All medical treatments caused a significant decrease in the volume of myomas (group T, p