Goserelin acetate to avoid hysterectomy in pre-menopausal women with fibroids requiring surgery

Objective: To obtain information on the efficacy of repeated short cycles o f GNRH agonist treatment in order to avoid hysterectomy in near-menopausal women with symptomatic fibroids. Study design: 72 pre-menopausal women (mea n age 50 years) with one or more uterine fibroids >10 cm in diameter, sympt omatic menorrhagia lasting three months or more and haemoglobin=9 g/dl ente red the study. The patients were randomized with ratio of approximately 1:4 to: (a) immediate surgery; or (b) treatment with goserelin acetate. Patien ts randomized to goserelin acetate received a first cycle of 3.6 mg depot o nce every 28 days for four months. They were followed-up for three years. I f menorrhagia was observed during the follow-up the woman was given goserel in acetate 3.6 mg depot for another three months. In case of further menorr hagia, a third cycle of goserelin acetate 3.6 mg depot for three months was given. After the third cycle of therapy if there was still menorrhagia, th e patient underwent hysterectomy plus bilateral oophorectomy. Results: A to tal of 13 women were assigned to the immediate surgery group and 59 to gose relin. Three years after trial entry a total of 23 women allocated to goser elin acetate treatment had undergone hysterectomy. Conclusion: This study s uggests that GNRH agonists are efficacious for avoiding hysterectomy in wom en near menopause with uterine fibroids. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.