Randomized double-blind study evaluating the efficacy on uterine fibroids shrinkage and on intra-operative blood loss of different length of leuprolide acetate depot treatment before myomectomy

Object. To determine whether length of pre-operative treatment with gonadot rophin-releasing hormone agonists (GnRHa) may have different effects on ute rine shrinkage and intra-operative blood loss, 36 patients with symptomatic uterine fibroids awaiting myomectomy were randomly divided into two groups . Method. Twenty patients received long-term GnRHa administration, six monthl y depot injections of leuprolide acetate (LA), while 16 patients were treat ed with two monthly LA injections before surgery. The hemoglobin concentrat ion and estradiol, follicle-stimulating hormone and luteinizing hormone con centrations were measured before and after treatment in both groups. Results. Uterine volume decreased in the long-term treated group from 680 /- 276 cm(3) to 486 +/- 195 cm(3) (36%) after two and to 388 +/- 172 cm(3) (51%) after six LA injections. In the short-term treated group the basal ut erine volume decreased from 745 +/- 320 cm(3) to 456 +/- 177 cm(3) (39%) af ter two LA injections. The uterine volume decrease was statistically signif icant (p<0.05) after two LA injections in both groups while the decrease ob served between two and six LA injections was not significant (p>0.05). The intra-operative blood-loss was not significantly different between the two groups studied, 315 +/- 93 cm(3) and 336 +/- 88 cm(3). Conclusion. Two pre-operative GnRHa depot injections offer similar results, in terms of uterine shrinkage and intra-operative blood loss, and a longer treatment seems to be justified in cases of anemia.