TOTAL VAGINAL HYSTERECTOMY AFTER ADMINISTRATION OF GNADOTROPHIN RELEASING HORMONE AGONIST IN A PATIENT WITH LARGE UTERINE LEIOMYOMA : CASE REPORT

「Abstract」: Gonadotrophin releasing hormone agonist (GnRHa) was given to a patient with uterine leiomyomas whose anticipated weight of the uterus was 973g. After the administration, the total uterine weight decreased to 658g. As a result, we were able to perform total vaginal hysterectomy (TVH) safely.「Introduction」In total hysterectomy generally performed for uterine leiomyoma, there are two methods ; total abdominal hysterectomy (TAH) and total vaginal hysterectomy (TVH). It is generally known that TVH is superior to TAH in (1) operative time, (2) postoperative pain, (3) hospitalization period, (4) surgical wound on the abdomen. We have reported that when the weight of the uterus to be extirpated is less than 700g, TVH could be performed safely1). On the other hand, gonadotrophin releasing hormone agonist (GnRHa) has an action of contracting uterine leiomyoma2). Therefore, if a uterine leiomyoma with an anticipated weight of about 900g can be contracted to a weight of less than 700g by administrating GnRHa before operation, TAH can be avoided, and there arises a possibility of performing TVH safely.