GONADOTROPIN-RELEASING-HORMONE AGONIST TREATMENT BEFORE HYSTEROSCOPICENDOMETRIAL RESECTION

OBJECTIVES. To evaluate the effects of treatment with the gonadotropin releasing hormone (GnRH) agonist goserelin before endometrial resecti on on absorption of distension medium fluid and technical feasibility of the surgical procedure. METHODS: Fifty-five patients reporting meno rrhagia underwent endometrial resection after 2 months of goserelin de pot therapy (33 cases) or during the proliferative phase of the cycle (22 controls). RESULTS. In the cases, the mean distension medium defic it +/- S.D. was 511 +/- 196 ml versus 647 +/- 245 ml in controls (P = 0.03), and the operating times Mere, respectively, 14 +/- 4 versus 18 +/- 5 min (P = 0.002). The intrauterine operating conditions were cons idered excellent or good in 64%; of the cases versus 27% of the contro ls (x(2) = 5.60, P = 0.02). CONCLUSIONS. GnRH agonists induce endometr ial thinning, so that when administered before intrauterine interventi ons, mucus cellular debris and bleeding should be reduced during surge ry and hysteroscopic visibility increased, the operating time may, thu s be shorter and fluid absorption decreased However, more data are nee ded before considering GnRH agonists a proven effective means of facil itating endometrial resection.