Leuprorelin depot 3.75 mg versus lynestrenol in the preoperative treatmentof symptomatic uterine myomas: a multicentre randomised trial

Objectives: To compare the effect of the gonadotrophin-releasing hormone ag onist leuprorelin and progestin lynestrenol, given prior to surgical treatm ent of symptomatic uterine myomas, on the pre-operative symptoms, tolerance , and operative blood loss. Study design: Fifty-six women were randomly sel ected to receive, during 16 weeks, either monthly subcutaneous injections o f leuprorelin 3.75 mg sustained release (n=33) or lynestrenol 5 mg two tabs per day (5th to the 25th menstrual cycle) (n=23). Results: Intent-to-treat analysis of the main efficacy criterion, namely ultrasonographic reduction of myoma(s) diameter, showed a significant difference in favour of leupror elin (P=0.02) with a mean decrease of 26.5+/-4.5% (n=29) as opposed to 7.3/-5% in the lynestrenol group (n=17). Clinical improvement was satisfactory in both groups. Hematocrit decrease between the preoperative value and the value measured 48 h postoperatively was significantly lower in the leupror elin group than in the lynestrenol one (P=0.02) (for hemoglobin: P=0.07). C onclusion: Leuprorelin was more effective than lynestrenol because of its m ore intense antigonadotropic activity. The tolerance was good, reflecting e ach drug mechanism of action. (C) 2000 Elsevier Science Ireland Ltd. All ri ghts reserved.