GOSERELIN ACETATE (ZOLADEX) PLUS ENDOMETRIAL ABLATION FOR DYSFUNCTIONAL UTERINE BLEEDING - A LARGE RANDOMIZED, DOUBLE-BLIND-STUDY

Objective: To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding. Design: Multicenter, prospective, randomized, double-blind study. Patient(s): Cycling premenopausal women with dysfunctional uterine bleeding. Trea tment: Patients were randomized to goserelin or placebo (sham depot) o nce monthly for 2 months prior to endometrial ablation. Treatment was timed to allow surgery 6 weeks later on day 7 of the menstrual cycle. Main Outcome Measure(s): Amenorrhea rates, endometrial histology and t hickness, pain and blood loss scores, and surgical parameters. Result( s): At 24 weeks after surgery, significantly more goserelin than place bo patients experienced amenorrhea (40% versus 26%). Blood loss was re duced from baseline, but not different between the groups. At surgery, mean endometrial thickness was 1.6 mm and 3.4 mm for the goserelin an d placebo groups, respectively, with significantly more atrophic gland s and stroma in the goserelin group. Surgery was significantly shorter (by 22%) and easier in the goserelin than in the placebo group, with a significantly lower median fluid absorption in the goserelin groups. in both groups, pain scores were reduced, patient satisfaction was hi gh (>92%), and re-intervention rate was low (2.8%). Conclusion(s): Gos erelin in combination with endometrial ablation was superior to endome trial ablation alone for the treatment of dysfunctional uterine bleedi ng. (C) 1997 by American Society for Reproductive Medicine.