GnRH analogue treatment before hysteroscopic resection of submucous myomas: a prospective, randomized, multicenter study

Objective To evaluate the efficacy of GnRH analogue treatment before hysteroscopic resection of submucous myomas in patients with abnormal uterine bleeding. Design Multicenter, prospective, randomized, clinical study. Setting Tertiary-care university hospitals. Patient(s) Thirty-nine consecutive patients with submucous myomas graded as G0 or G1 according to the European Society for Gynecological Endoscopy classification (myoma size 10–35 mm). Intervention(s) Patients were randomized to either direct surgery or 2 months of GnRH analogues before undergoing hysteroscopic resection of the submucous myoma. Main Outcome Measure(s) Operating times, fluid absorption, difficulty of the operation, surgeon satisfaction with the procedure, intra- and postoperative complications, postoperative pain, and patient satisfaction were recorded. Result(s) Patients treated with GnRH analogue had significantly shorter operative times (15.9 ± 3.1 minutes vs. 21.3 ± 4.0 minutes) and significantly reduced fluid absorption (378 ± 137 mL vs. 566 ± 199 mL) compared with no preoperative medical treatment. Operative difficulty and overall surgeon satisfaction were significantly better in the GnRH analogue group. Patient satisfaction was similar in the two groups. Conclusion(s) GnRH analogue treatment before hysteroscopic resection of G0-G1 10–35 mm submucous myomas was effective in reducing operative times, fluid absorption, and difficulty of the procedure.