TRIAL OF ROUTINE GONADOTROPIN-RELEASING-HORMONE AGONIST TREATMENT BEFORE ABDOMINAL HYSTERECTOMY FOR LEIOMYOMA

Objective. To investigate the usefulness of a routine short term treat ment with gonadotropin releasing hormone agonist (D-Trp-6-LHRH depot) before abdominal hysterectomy for leiomyoma. Study Design. Prospective , comparative, randomized study. Setting. A teaching hospital of Barce lona University. Patients. Fifty premenopausal women requiring hystere ctomy as treatment for symptomatic leiomyomas. Twenty-three patients w ere randomized to receive gonadotropin releasing hormone agonist treat ment before hysterectomy (cases), and 27 patients were randomized to i mmediate hysterectomy (controls). Main outcome measures. Type of abdom inal incision, operating time, operative hemoglobin and hematocrit dec rease, postoperative morbidity, and days in hospital. Results. In the agonist treated group mean uterine volume decreased and mean hemoglobi n and hematocrit significantly rose after 8 weeks of treatment. Operat ive time was similar in both groups of patients but the number of wome n having Pfannenstiel incision was significantly higher in the cases. Mean operative hemoglobin and hematocrit decrease and postoperative mo rbidity were lower in the cases. There was a trend for shorter postope rative hospital stays in the agonist treated group. Conclusions. Our r esults favor the routine use of a short term gonadotropin releasing ho rmone agonist treatment before abdominal hysterectomy for leiomyoma in order to decrease operative blood loss and postoperative morbidity.