The Comparison of Therapeutic Efficacies of Two Preoperatively-
Administered Gonadotropin Releasing Hormone Analogs on
Symptomatic Uterine Leiomyomas

Melih Atahan GÜVEN, İbrahim Egemen ERTAŞ
Kahramanmaraş-Turkey

OBJECTIVE: The aim was to determine the therapeutic efficacies of two different gonadotropin-releasing hormone analogs in patients with symptomatic uterine leiomyoma.
STUDY DESIGN: Twenty women with symptomatic uterine leiomyomas awaiting elective surgical treatment (either myomectomy or hysterectomy) were randomly divided into two groups. Nine patients received gosereline acetate 3.6 mg (ZoladexÒ, Astra Zeneca) subcutaneously and 11 patients triptoreline acetate 3.75 mg (DecapeptylÒ, Ipsen Pharmaceuticals) intramusculary every four weeks for a period of 12 weeks beginning on one of the first three days of the menstrual cycle. Changes in myoma volume were ascertained by magnetic resonans imaging (n:18) or computed tomography (n:2). Hormone profiles were obtained for both groups before and after completion of therapy. Surgical treatment was carried out three to five weeks after the last administration of the gonadotropin-releasing hormone analog.
RESULTS: Leiomyoma volume decreased in the triptoreline acetate group from 121±221 mm3 to 41±40 mm3 (P=0.003) and in the gosereline acetate group from 239±352 mm3 to 98±146 mm3 (p=0.008) after the therapy. The post-therapy FSH level was significantly lower in the triptoreline acetate group (5.6±1.9 versus 9.2±4.2, p=0.007).
CONCLUSION: GnRH-analogs are an effective therapeutic tool for reduction of myoma size. Two pre-operative GnRH-analogs shows similar results, in terms of uterine shrinkage and basal hormon profiles.
(Gynecol Obstet Reprod Med 2005; 11:180-182)

Key Words: Gonadotropin-releasing hormone analog, Leiomyoma, Magnetic resonans imaging