goserelin and Pain

Although there are various hormone therapies, including gonadotropin-releasing hormone agonist, danazol, levonorgestrel-releasing intrauterine system, dienogest, and low-dose estrogen progestin, no consensus opinion has been reached in terms of which medication should be used and for how long it should be administered. We aimed to determine whether dienogest or goserelin is the better postoperative therapy to prevent recurrence of endometriosis.. A prospective cohort randomized study were conducted, including 198 patients diagnosed as having endometriosis. A total of 111 patients were randomly assigned into two groups: the dienogest-administered group (n = 56) and the goserelin-administered group (n = 55). Patients were followed for 24 months after laparoscopic surgery. Those who gave consent but desired no postoperative therapy were assigned to the non-treatment group (n = 79). Recurrence, side-effects, degrees of menstrual pain and chronic pelvic pain measured by the Visual Analogue Scale were compared among the three groups: the dienogest, goserelin, and non-treatment groups.. No significant difference was observed in the postoperative recurrence rate between the dienogest and goserelin groups. No significant difference was found in the recurrence rate between the goserelin group and non-treatment group; however, a significant difference was found in the recurrence rate between the dienogest group and the non-treatment group (P = 0.027). Menstrual pain and chronic pelvic pain were significantly improved in both treatment groups. Side-effects were markedly observed in the goserelin group as compared with the dienogest group.. Dienogest is available for prolonged administration of more than 6 months, so it is more useful than goserelin, which is available only for short-term administration.

Topics: Adult; Conservative Treatment; Endometriosis; Female; Gonadotropin-Releasing Hormone; Goserelin; Hormone Antagonists; Humans; Nandrolone; Pain; Postoperative Care; Prospective Studies; Recurrence; Secondary Prevention

To evaluate the clinical outcomes of gonadotropin-releasing hormone analog (GnRHa) combined with implantation of a levonorgestrel-releasing intrauterine system (LNG-IUS) in adenomyosis patients with significantly enlarged uteruses.. Twenty-one adenomyosis patients whose uterine volumes were greater in size than at 12 weeks' gestation were recruited for the study. Subcutaneous injection of GnRHa was administrated at an interval of 28 days for a total of 3-4 cycles when uterine length was determined to be less than 10 cm by ultrasound measurement. At 3, 6 and 12 months after LNG-IUS implantation, follow-up was performed to document the clinical values such as uterine volume, degree of dysmenorrhea and menstrual flow.. Twelve months after implantation, the menstrual flow was significantly lower than baseline values (53.8 ± 11.7 vs. 100, p = 0.03). The degree of dysmenorrhea (pain) was relieved 12 months after implantation (58.2 ± 11.5 vs. 93.7 ± 0.2, p = 0.005). Uterine volume was also below pre-GnRHa levels after implantation (276.6 ± 32.1 vs. 311.4 ± 32.3, p = 0.005). LNG-IUS was expelled in 3 patients, giving an expulsion rate of 14%. Side effects of GnRHa combined with LNG-IUS implantation were few.. The findings indicate that combined GnRHa and LNG-IUS treatment was efficacious in patients with enlarged adenomyosis.

Topics: Adenomyosis; Drug Delivery Systems; Dysmenorrhea; Female; Goserelin; Humans; Intrauterine Devices, Medicated; Levonorgestrel; Organ Size; Pain; Progestins; Uterus

LH-RH agonist is the key drug in hormonal therapy for premenopausal patients with breast cancer. It is important to reduce the pain related to injecting the LH-RH agonist, because patients must continue the medication for several years. We developed a way to reduce the pain by cooling the needle injecting site with a frozen ice pack. 18 premenopausal postoperated women filled out a questionnaire on the severity of pain upon injecting Goserelin acetate compared with the pain without this cooling method and pretreatment. We estimated the pain by a Numerical Rating Scale(NRS). The NRS scores of this cooling method revealed the pain to be significantly less than by control method(p<0. 005). This cooling method could be useful for the reduction of pain upon injecting the LH-RH agonist.

Topics: Antineoplastic Agents, Hormonal; Breast Neoplasms; Female; Goserelin; Humans; Ice; Injections; Pain; Pain Measurement; Surveys and Questionnaires

To compare clinical effect of gonadotropin releasing hormone agonist (GnRH-a) alone and GnRH-a combined with low-dose dydrogesteronea and estradiol valerate on sex hormone, hypoestrogenic symptoms, quality of life and bone mineral density (BMD) in treatment of endometriosis.. Seventy patients with moderate or severe endometriosis, who were diagnosed by laparotomy or laparoscopic surgery within two months, were randomly assigned into two groups. 35 patients in GnRH-a group were treated by goserelin (3.6 mg) for three months, and 35 patients in add-back group were treated by goserelin (3.6 mg) combined with estradiol valerate 0.5 mg and dydrogesteronea 5 mg daily. Before and after the treatment, clinical parameters were recorded and analyzed, including visual analog scale (VAS), medical outcomes survey short form 36 (SF-36), Kupperman menopausal index (KMI), BMD, the serum level of follicle stimulating hormone (FSH), estradiol (E2) and bone gla-protein (BGP). The first menstruation and VAS were also followed up after treatment.. Every 3 cases in two groups lost follow-up. (1) Reproductive hormone: the level of E2 in add-back group [(94+/-71) pmol/L] was significantly higher than (54+/-52) pmol/L in GnRH-a group (P<0.01). The level of FSH in add-back group [(3.0+/-1.9) U/L] was significantly lower than (5.7+/-2.9) U/L in GnRH-a group (P<0.05). (2) VAS: after treatment, VAS in both group decreased significantly when compared with that before treatment (P<0.05), and remained until menstruated. (3) KMI: KMI in add back-group (10+/-8)was significantly lower than (14+/-6) in GnRH-a group (P<0.05). (4) BMD: compared with that before treatment, BMD decreased significantly after treatment in GnRH-a group (P<0.05), no remarkable difference of BMD was observed before and after treatment in add-back group. Before treatment, serum BGP in both groups did not show statistical difference. After treatment, the level of BGP in GnRH-a group [(7932+/-5206) ng/L] was significantly higher than (5419+/-2917) ng/L in add-back group (P<0.05).. GnRH-a combined with estrogen-progesterone regimen could relieve pain from endometriosis as effectively as GnRH-a alone and reduce hypoestrogenic symptoms and bone loss. Therefore, it is a safe and effective treatment.

Topics: Adolescent; Adult; Bone Density; Drug Administration Schedule; Dydrogesterone; Endometriosis; Estradiol; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Goserelin; Humans; Middle Aged; Osteocalcin; Pain; Quality of Life; Severity of Illness Index; Treatment Outcome; Young Adult

To evaluate effects and safety of gonadotrophin-releasing hormone agonist (GnRH-a) combined with transdermal estradiol and medroxyprogesterone acetate in the treatment of endometriosis.. From January 1st, 2007 to July 31st, 2007, 28 endometriosis patients underwent laparoscopic or transabdominal surgery in Obstetrics and Gynecology Hospital affiliated to Fudan University were randomly divided into group A and group B. 14 patients in group A received 3.6 mg goserelin once every 4 weeks, 12 weeks in all. 14 patients in group B received goserelin and added 1/2 piece of half-hydrate estradiol every week and 6 mg oral medroxyprogesterone acetate per day, 12 weeks in all. Serum estradiol (E2), follicle stimulating hormone (FSH), bone gla protein levels, visual analogue scale (VAS) of pain, bone mineral density of lumbar spine, vaginal exfoliate cell spurs and the form of Kupperman were compared in patients before and after treatment.. (1) After treatment, the level of FSH and E2 levels were (5.0 +/- 2.6) U/L and (29 +/- 17) pmol/L in group A and (3.0 +/- 1.5) U/L, and (87 +/- 53) pmol/L in group B, which were significantly lower than those before treatment [FSH (17.0 +/- 12.2) U/L, and E2 (184 +/- 194) pmol/L in group A and FSH: (15.3 +/- 13.6) U/L and E2: (281 +/- 242) pmol/L in group B, P < 0.01]. On the seventh day after three-month GnRH-a treatment, it was observed that the level of E2 was higher and FSH was lower in group B than the level of E2 and FSH of group A (P < 0.01). (2) After treatment, the basal vaginal exfoliate cell proportion in group A [(66.2 +/- 29.0)%] was significantly lower than that in group B [(11.8 +/- 28.0)%, P < 0.01]; while patients in group A owned a lower proportion of the middle [(29.1 +/- 23.1)%], superficial layers [(4.0 +/- 5.5)%] and esinophilic cells [(2.3 +/- 2.6)%] than patients group B [middle layer: (73.0 +/- 25.2)%; superficial layer: (15.2 +/- 10.9)%; esinophilic cells: (10.8 +/- 7.9)%; P < 0.01. (3) Before the treatment, patients'VAS scores of total, pelvic pain, dysmenorrheal and dyspareunia were 7.43 +/- 3.20, 2.35 +/- 1.82, 4.93 +/- 1.98 and 0.14 +/- 0.53 in group A and were 7.71 +/- 2.02, 2.57 +/- 1.60, 4.86 +/- 1.56 and 0.29 +/- 1.07 in group B; after treatment, the scores above were changed to 0. 14 +/- 0.36, 0.07 +/- 0.27, 0.07 +/- 0.27 and 0 in group A and 0.36 +/- 0.50, 0.29 +/- 0.47, 0.07 +/- 0.27 and 0 in group B, which were all significantly lower than those before treatment separately (P < 0.01). When menstruation recovered, the scores were 0.21 +/- 0.43, 0.07 +/- 0.27, 0.14 +/- 0.36, and 0 in group A and 0.50 +/- 0.65, 0.29 +/- 0.47, 0.21 +/- 0.43 and 0 in group B, which were also significantly lower than those before treatment (P < 0.01), however, no statistical difference was found between groups at any time spot (P > 0.05). (4) In group A, the bone density after treatment [(0.96 +/- 0.06) g/cm2] was lower than that before treatment [(0.99 +/- 0.06) g/cm2, P < 0.01)]. In group B, the index was (0.98 +/- 0.09) g/cm2, which was lower than that before treatment [(0.99 +/- 0.10) g/cm2, P = 0. 201]. No statistical difference was found between groups (P > 0.05). The bone loss rate were (-2.77 +/- 1.97)% in group A and (-0.93 +/- 2.86)% in group B (P = 0.058). Before treatment, the bone gla protein was (13 +/- 3) microg/L in group A and (13 +/- 6) microg/L in group B. After treatment, the bone gla protein levels was (17 +/- 6) microg. The add-back therapy that consists of an estradiol patch and oral medroxyprogesterone acetate is effective and safe treatment for endometriosis.

Topics: Administration, Cutaneous; Administration, Oral; Adult; Calcitonin; Drug Therapy, Combination; Endometriosis; Estradiol; Female; Follicle Stimulating Hormone; Goserelin; Humans; Medroxyprogesterone Acetate; Menstrual Cycle; Pain; Treatment Outcome

To determine whether needle size influences a patient's perception of pain, 50 patients requiring hormonal manipulation for prostate cancer were blindfolded and randomised to receive two goserelin ('Zoladex') or two leuprorelin ('Prostap') injections, using 16- or 23-gauge needles, respectively. Median visual analogue scale pain scores for the first injections of goserelin and leuprorelin were below the level of clinical significance and were not statistically different. Mean administration time for goserelin was significantly shorter than for leuprorelin. In conclusion, there was no statistically significant difference in pain experienced on injection of goserelin and leuprorelin when patients were unaware of needle size.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Goserelin; Humans; Leuprolide; Male; Middle Aged; Needles; Pain; Pain Measurement; Patient Satisfaction; Prostatic Neoplasms; Single-Blind Method

To evaluate the efficacy of bicalutamide vs cyproterone acetate in preventing PSA flare (as a surrogate for tumour flare) for patients requiring luteinizing hormone-releasing hormone (LHRH) analogue therapy for prostate cancer.. In this pilot study, 40 men were randomized 1 : 1 to bicalutamide 50 mg o.d. or cyproterone acetate 100 mg t.i.d. 5 days prior to goserelin acetate and continued for 21 days thereafter. PSA, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone were obtained before treatment and on days 6, 8, 10, 16, 21 and 28. Primary end point was PSA. Hormone profile and clinical features including urinary symptoms and bone pain were secondary end points.. Both groups were equally matched apart from serum creatinine and ALP. The speed and magnitude of the percentage change in median PSA from baseline was increased for the CPA group but there was no statistically significant difference in the two groups. Although those receiving bicalutamide all showed a testosterone peak, this remained within the normal range. No difference in the frequency of drug-specific adverse events was found. None of the patients died or developed cord compression during the study period.. Bicalutamide is able to suppress the initial PSA surge as effectively as cyproterone acetate albeit slightly delayed. A statement whether bicalutamide is equally good at preventing clinical flare cannot be made and should be assessed in an appropriately powered study.

Topics: Aged; Androgen Antagonists; Anilides; Antineoplastic Agents, Hormonal; Biomarkers, Tumor; Cyproterone Acetate; Goserelin; Humans; Injections, Subcutaneous; Male; Nitriles; Pain; Prostatic Neoplasms; Tosyl Compounds

Breast pain is a common symptom in patients attending breast clinics. The purpose of this study was to evaluate the efficacy of goserelin (Zoladex) as compared with sham injection in patients with mastalgia.. One hundred forty-seven premenopausal women were randomized to treatment with either goserelin injection (3.6 mg/month) or sham injection for a total of 6 injections. Patients' daily self-assessment of breast pain using Cardiff breast pain chart was recorded during the 6-month treatment period and for 6 months in the posttreatment period.. A significant treatment difference between the 2 groups in favor of goserelin was noted during the treatment period. Mean breast pain score improved by 67% in the goserelin group and 35% in the sham group during the treatment period. The mean pain scores increased in both groups in the posttreatment period. No significant posttreatment difference was found between the two groups. Side effects were more common with goserelin than sham injection. Patients receiving goserelin experienced vaginal dryness, hot flushes, decreased libido, oily skin or hair, and a decrease in breast size more frequently than sham patients.. Goserelin is an effective short-term treatment for mastalgia. However, side effects are common, and thus, goserelin should be kept in reserve for patients who are refractory to other forms of treatment. Potentially, goserelin could be used to induce a rapid relief of symptoms that could be maintained with alternative therapies.

Topics: Adult; Analysis of Variance; Breast Diseases; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Female; Follow-Up Studies; Goserelin; Humans; Injections, Subcutaneous; Middle Aged; Pain; Pain Measurement; Patient Satisfaction; Probability; Risk Assessment; Severity of Illness Index; Treatment Outcome

Luteinising hormone releasing hormone (LHRH) analogues are routinely used in the treatment of patients with advanced prostate cancer. This randomised crossover trial was conducted to compare patient comfort and tolerability between two commonly used LHRH analogues: goserelin acetate and leuprorelin acetate. A total of 50 patients were randomised into two groups, each receiving 6-monthly injections of leuprorelin acetate (a liquid presentation) and goserelin acetate (a depot pellet) and crossing over between treatments. Patients completed a simple visual analogue score for the discomfort felt from the injections. An analysis of variance model was used, and the results found that patients do tolerate leuprorelin acetate (0.589) better than goserelin acetate (1.343) (P < 0.001, CI = 95%).

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Cross-Over Studies; Delayed-Action Preparations; Goserelin; Humans; Injections, Subcutaneous; Leuprolide; Male; Middle Aged; Pain; Prostatic Neoplasms

Subjective quality-of-life assessments obtained from investigators and patients were compared in a subset of 76 patients from an EORTC study (protocol 30853) on metastatic prostatic carcinoma. In this study the therapeutic effect of orchiectomy was compared with a luteinizing hormone-releasing hormone analogue depot preparation and flutamide in 327 patients in total. Pretreatment, 6- and 12-month quality-of-life assessments revealed large variations between the patients' and the investigators' evaluation of performance status and sexual status (potency). Correlation analysis showed that reduced social life, impaired sexual potency and fatigue played important roles in overall psychological well-being. It was concluded that quality-of-life assessments obtained by self-administration questionnaires is a feasible approach and provides a tool to evaluate the benefits of treatment in prostate cancer.

Topics: Activities of Daily Living; Flutamide; Goserelin; Humans; Interpersonal Relations; Male; Orchiectomy; Pain; Prostatic Neoplasms; Quality of Life; Sexual Behavior; Surveys and Questionnaires; Urination Disorders

To evaluate the efficacy of goserelin versus a low-dose cyclic oral contraceptive (OC) in improving pelvic pain in women with endometriosis and to compare recurrence of symptoms during follow-up.. Open-label, randomized trial.. University hospital endometriosis center.. Fifty-seven women with moderate or severe pelvic pain and laparoscopically diagnosed endometriosis.. Six-month treatment with goserelin depot (n = 29) or a low-dose cyclic OC (n = 28) followed by 6-month follow-up.. Variation in severity of symptoms during treatment and at the end of follow-up as shown by a linear analog scale and a verbal rating scale.. At 6 months of treatment, a significant reduction in deep dyspareunia was observed in both groups, with goserelin superior to the OC at linear analog scale assessment. Nonmenstrual pain was diminished on both scales without differences between treatments. Women taking the OC experienced a significant reduction in dysmenorrhea. At the end of follow-up, symptoms reappeared without differences in severity between the groups.. Low-dose cyclic OCs may be a valuable alternative for the treatment of dysmenorrhea and nonmenstrual pain associated with endometriosis. Symptoms recurred in most subjects 6 months after drug withdrawal.. Physicians at the University of Milan in Italy compared data on 29 endometrial patients who received 3.6 mg goserelin in a 28-day subcutaneous depot formulation for 6 months to treat nonmenstrual pelvic pain, dysmenorrhea, and pain during coitus (dyspareunia) with data on 28 other endometrial patients treated with a low-dose monophasic oral contraceptive (OC) (.02 mg ethinyl estradiol and 0.15 mg desogestrel) for 6 months. They followed the women for 6 months after treatment ended. The physicians wanted to determine the efficacy of goserelin, a gonadotropin-releasing hormone (GnRH) agonist, versus a low dose OC to relieve pelvic pain in patients with endometriosis and to compare pain recurrence after drug withdrawal. (GnRH agonists are current medical treatments for pelvic pain, but they have several side effects and are expensive; and therefore their use is restricted.) At the end of treatment, both goserelin and the low-dose OC significantly reduced dyspareunia (p .01), especially goserelin according to the linear analog scale (pain symptom score, 1.8 points lower). Both treatments improved nonmenstrual pain equally at the end of treatment (p .01). The low-dose OC reduced dysmenorrhea greatly at the end of treatment (p .01). The researchers could not evaluate dysmenorrhea in goserelin cases, since these patients experienced amenorrhea. The only persistent significant reduction at the end of follow-up occurred with dyspareunia in goserelin patients (p .05). In the other patients, pelvic pain returned to baseline levels 6 months after treatment ended. The severity of pelvic pain did not differ between groups 6 months after follow-up. These results suggested that low-dose OCs may be an effective alternative treatment for dysmenorrhea and nonmenstrual pelvic pain linked to endometriosis.

Topics: Adolescent; Adult; Contraceptives, Oral; Dysmenorrhea; Dyspareunia; Endometriosis; Female; Follow-Up Studies; Goserelin; Humans; Pain; Recurrence

The independent prognostic factors affecting survival were assessed in 240 men undergoing treatment for metastatic prostate cancer as part of a randomized clinical trial comparing the gonadotropin releasing hormone analogue Zoladex (goserelin acetate implant) with castration. In a multivariate analysis, the most highly significant predictors were the presence or absence of bone pain, serum testosterone levels, serum alkaline phosphatase levels, and performance status. Patients with all four factors favorable for survival had a 2-year survival rate of 84% as compared with only 8% for patients with none of the four factors favorable for survival. No other factors were significant. A separate analysis of serum testosterone levels revealed that the higher the pretreatment serum testosterone level, the greater the survival rate. Compared with patients with serum testosterone levels less than 6.9 nmol/L, significant differences in survival were observed for patients with serum testosterone levels of 10.4 to 13.9, 13.9 to 17.3, and over 17.3 nmol/L. These results have important implications for the design and analysis of future clinical trials of hormone therapy and for counseling patients regarding the short-term prognosis of their disease.

Topics: Alkaline Phosphatase; Buserelin; Follow-Up Studies; Goserelin; Humans; Male; Multivariate Analysis; Orchiectomy; Pain; Prognosis; Prospective Studies; Prostatic Neoplasms; Survival Analysis; Testosterone

Topics: Adult; Breast; Buserelin; Female; Goserelin; Humans; Middle Aged; Pain; Placebos; United Kingdom

The efficacy of skin icing to reduce the pain of goserelin injection has been reported. We investigated the optimal icing time with a frozen gel pack and its effectiveness.. Abdominal skin temperatures of 49 healthy volunteers were measured after application of the frozen gel pack for 10, 15 and 30 s, and it was decided that a 15-second icing was adequate. For 55 consecutive patients who received goserelin (10.8 mg) injection, pain was evaluated employing a visual analog scale (VAS). The first injection was administered routinely. A second injection was administered after skin icing in 27 of 55 patients who wanted to try icing. At the time of the third injection, all patient decided whether they were to receive icing or the routine method.. After icing, VAS scores decreased in 20 of 27 patients. At the third injection, 18 patients requested icing.. When a patient complains of injection pain, the icing method should be considered for pain reduction.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Cold Temperature; Equipment Design; Gels; Goserelin; Humans; Hypothermia, Induced; Injections, Subcutaneous; Male; Middle Aged; Pain; Pain Measurement; Prostatic Neoplasms; Skin Temperature; Time Factors; Treatment Outcome

We investigated the effectiveness of using an ice pack for reducing the pain associated with goserelin acetate injection. In this study, 39 patients with prostate cancer and 1 patient with breast cancer receiving hormonal therapy with goserelin acetate were enrolled. All patients completed a questionnaire regarding the use of ice application. We used the numerical rating scale (NRS) to assess the pain associated with injection. The NRS scores indicated that the pain was significantly less with ice application than with the usual method (p < 0.001). Further, ice application could decrease the duration of pain sensation. Ice application at the injection site is safe and effective for reducing pain.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Cryotherapy; Female; Goserelin; Humans; Male; Middle Aged; Neoplasms; Pain; Pain Measurement; Surveys and Questionnaires

The objective of this study was to assess the usefulness of ice cubes and vapocoolant spray for relieving pain induced by goserelin acetate injections.. Fourty-seven patients with prostate cancer receiving hormonal manipulation by goserelin acetate were enrolled in this study. They received goserelin acetate injections after analgesic pretreatments with ice cubes until March 2009, and with vapocoolant spray and ethyl chroride after April 2009. We had them fill out a questionnaire asking whether they preferred to continue cooling pretreatments. We assessed the pricking pain using the face scale(FS)and the numerical rating scale(NRS).. The median FS and NRS scores at the first pretreatment(ice cube or vapocoolant spray)were lower than those at no pretreatment(p<0. 01 in both scores). Thirty-nine patients(83. 0%)preferred cooling pretreatment. Only 5 patients preferred no pretreatment. The differences in the median FS score and NRS score between ice cubes and vapocoolant spray were not significant(p=0. 353 in FS, p=0. 120 in NRS). No adverse events associated with the cooling pretreatment occurred except for late-onset subcutaneous hemorrhages in 2 cases.. The local cooling at the injection site of goserelin acetate was effective irrespective of the method(ice cube or vapocoolant spray)for the relief of pricking pain without causing serious complications.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Cold Temperature; Goserelin; Humans; Ice; Infusions, Intravenous; Male; Middle Aged; Pain; Prostatic Neoplasms; Surveys and Questionnaires; Treatment Outcome

To evaluate follicle loss and its associated factors during laparoscopic cystectomy for ovarian endometrioma.. Between October 2008 and December 2009, 140 patients with ovarian cysts undergoing laparoscopic cystectomy at Peking Union Medical Hospital were enrolled: 74 had ovarian endometrioma with no preoperative hormonal therapy (group A), 40 had ovarian endometrioma pretreated with GnRHa (group B), and 26 had non-endometriotic cysts (group C). Pre-, peri- , and postoperative clinical data were collected, and cyst specimens were evaluated histologically.. The number of capsules showing follicles and the mean number of follicles per capsule were lower in group C than in group A or B (P<0.05). Fewer type IIC than type IIB endometriomas showed follicles (P<0.05). The number of follicles per cyst was related negatively to disease duration but positively to pain severity. Women in group A with unilateral endometrioma had a lower mean dysmenorrhea score after the surgery (P<0.05), but no change in basal follicle-stimulating hormone (FSH).. The type of cyst, disease duration, and severity of dysmenorrhea were associated with ovarian follicle loss during laparoscopic excision of endometrioma. Laparoscopic unilateral cystectomy for endometrioma was effective in relieving pain but had little effect on serum FSH, which might reflect the remaining ovarian reserve.

Topics: Adolescent; Adult; China; Dysmenorrhea; Endometriosis; Female; Follicle Stimulating Hormone; Follow-Up Studies; Goserelin; Humans; Laparoscopy; Middle Aged; Ovarian Cysts; Ovarian Follicle; Pain; Retrospective Studies; Severity of Illness Index; Time Factors; Young Adult

Goserelin acetate, which is injected through a 16-gauge needle, makes some patients feel substantial, although tolerable, pain. We tried to clarify whether injection pain was reduced by icing the skin at the injection site.. Pain associated with the injection of goserelin acetate was prospectively evaluated in 48 patients who had received an 10.8-mg goserelin injection at least once previously. In this study, the first injection was administered by usual methods, and 3 months later a second injection was administered after icing the skin at the injection site. Pain intensity was evaluated by visual analogue scale (VAS) pain score.. VAS pain scores for the usual injection method were 32.4 ± 21.7 mm [mean ± 2 standard deviation (SD)] and was significantly lower (16.4 ± 17.9) for the icing method (p = 0.001, paired t test). Thirty-three (68.8%), eight (16.7%), and seven (14.6%) of the 48 patients reported a decrease, no change, and increase, respectively, in VAS pain score by the icing method.. Icing at the injection site of goserelin acetate is a safe and effective method to reduce injection pain. This method can be easily performed in daily practice if a patient complains of pain at the injection site.

Topics: Aged; Aged, 80 and over; Analgesia; Antineoplastic Agents, Hormonal; Chi-Square Distribution; Cold Temperature; Goserelin; Humans; Injections, Subcutaneous; Japan; Male; Middle Aged; Pain; Pain Measurement; Prospective Studies; Prostatic Neoplasms; Skin Temperature

To describe a case of gonadotropin-releasing hormone (GnRH) analogue-induced orchialgia and to outline a novel treatment for this debilitating adverse effect.. In this case report, we describe the clinical, laboratory, and imaging findings of the study patient and describe the treatment approach.. After 15 months of treatment with a GnRH analogue (goserelin acetate), a 76-year-old man with prostate cancer that had been treated with standard therapy presented with bilateral testicular pain that was refractory to simple analgesics. It was not possible to discern an etiology for the orchialgia from his history, and he had received no new prescription medications. On physical examination, he had no evidence of skin rash, inflammation, or abnormalities of the testes, although there was marked tenderness on palpation. Findings from testicular ultrasonography were unremarkable and confirmed normal anatomy and blood flow. His prostate-specific antigen nadir was satisfactory at 0.1 ng/mL, indicating a strong, persistent biochemical response to combined hormonal blockade and radiation therapy. The use of a steroidal antiandrogen (cyproterone acetate) effectively abated the reported testicular pain.. The use of GnRH analogues in the endocrine management of prostate cancer is becoming more widespread, and clinicians should be aware of orchialgia as a rare adverse effect. This is the first reported case of testicular pain in association with goserelin acetate, and we conclude that cyproterone acetate may have a useful role in managing this condition.

Topics: Aged; Androgen Antagonists; Cyproterone Acetate; Gonadotropin-Releasing Hormone; Goserelin; Humans; Male; Pain; Steroids; Testicular Diseases; Testis

Topics: Anesthetics, Local; Antineoplastic Agents, Hormonal; Drug Implants; Goserelin; Humans; Injections, Subcutaneous; Pain; Patient Compliance

Topics: Aged; Antineoplastic Agents, Hormonal; Attitude of Health Personnel; Drug Administration Schedule; Drug Implants; Education, Nursing, Continuing; Gonadotropin-Releasing Hormone; Goserelin; Health Services Needs and Demand; Humans; Injections, Subcutaneous; Male; Nurse's Role; Nursing Evaluation Research; Nursing Staff, Hospital; Pain; Patient Education as Topic; Prostatic Neoplasms; Surveys and Questionnaires

A 76-year-old man with prostate cancer T3N0M0 and increasing PSA was treated with goserelin three times in a half year. As soon as the first treatment, he described subjective muscle weakness. After the third treatment, he developed complex motoric symptoms and atypical central pain with a likely association to goserelin. His left arm had signs of spastic movement; pain deteriorated after relaxation. The right hand showed muscle cramps under passive movements of the left arm that were not typical for rigor. He felt aching and partial burning pain in his whole body. There were few allodynic areas, mainly in the left arm. Several treatment approaches failed and the patient died some weeks after the first contact with our pain clinic due to pneumonia.

Topics: Aged; Dyskinesia, Drug-Induced; Fatal Outcome; Goserelin; Humans; Male; Muscle Weakness; Pain; Prostatic Neoplasms

To evaluate the usefulness of the histological classification of endometriosis in predicting responses to treatment.. We evaluated 412 biopsy specimens from 241 patients with pelvic endometriosis. Pain and infertility were evaluated before surgery. Disease location and stage of development were analyzed according to the 1985 American Society of Reproductive Medicine (ASRM) classification. Histological findings were classified as stromal, well-differentiated, undifferentiated, and mixed endometriosis. Clinical response to pain or infertility was evaluated.. Histological findings, disease location and stage of development, and response to treatment were compared. Undifferentiated endometriosis was more frequently associated with stages III/IV than the well-differentiated and stromal histological types. Pure or mixed undifferentiated patterns were more frequently associated with rectovaginal endometriosis. When considering pain symptoms, patients presenting well-differentiated or stromal histological patterns responded better to therapeutic treatment than those who presented undifferentiated histological patterns. There were no significant differences in cases related to sterility.. The histological categorization of endometriosis can help predict the behavioral patterns of the disease.

Topics: Adolescent; Adult; Antineoplastic Agents, Hormonal; Endometriosis; Female; Goserelin; Gynecologic Surgical Procedures; Humans; Infertility, Female; Pain; Pain Management; Predictive Value of Tests; Treatment Outcome

Topics: Adult; Alopecia; Breast Diseases; Estrogen Antagonists; Female; Goserelin; Humans; Pain; Tamoxifen

Topics: Adult; Dysmenorrhea; Female; Goserelin; Humans; Laparoscopes; Laparoscopy; Pain; Surgical Staplers; Ultrasonography; Uterus

Topics: Cryotherapy; Ethyl Chloride; Goserelin; Humans; Pain

Topics: Anti-Inflammatory Agents, Non-Steroidal; Breast Diseases; Bromocriptine; Danazol; Fatty Acids, Essential; Female; gamma-Linolenic Acid; Goserelin; Humans; Linoleic Acids; Oenothera biennis; Pain; Periodicity; Plant Oils; Premenstrual Syndrome; Tamoxifen

Mild breast pain and nodularity are common and may be considered normal. Only when symptoms are severe enough to affect the patient's lifestyle should drug treatment be considered. Using danazol, bromocriptine or evening primrose oil a clinically useful improvement in pain can be anticipated in 77% of patients with cyclical mastalgia and 44% with non-cyclical mastalgia. Benign nodularity should not be biopsied surgically as it is unnecessary and makes subsequent assessment of the breast difficult.

Topics: Adult; Age Factors; Breast Diseases; Bromocriptine; Buserelin; Danazol; Estrogen Replacement Therapy; Fatty Acids, Essential; Female; gamma-Linolenic Acid; Goserelin; Humans; Hypolipidemic Agents; Linoleic Acids; Oenothera biennis; Pain; Plant Oils; Tamoxifen

One hundred eighteen patients with stage D (D1 or D2) prostate cancer with a mean age of 69 years were treated with monthly goserelin (Zoladex; ICI 118, 630; ICI Americas Inc, Wilmington, DE, property of Imperial Chemical Industries PLC) injections and the data were analyzed for predictive parameters for best response and time to treatment failure (National Prostatic Cancer Project [NPCP] and Eastern Cooperative Oncology Group [ECOG] criteria). For best response in a univariate analysis, the performance status (PS 0-1 v 2-3) (P = .01), hematocrit (P = .04), and pain (P = .04) were significant. For time to treatment failure by univariate analysis, ECOG performance status (0-1 v 2-3) was most predictive (P less than .0001), followed by pain at entry (P = .0002), initial testosterone (T) level (greater than 250 ng/dL) (P = .0005), age less than 69 years (P = .02), alkaline phosphatase (less than 115 IU/L) (P = .03), hemoglobin (less than 14 g/dL) (P = .03), whereas normal acid phosphatase (less than 3 IU/mL) (P = .29) was not predictive. In multivariate analysis for time to treatment failure, only the ECOG performance status was of significance (P = .01). Estimated median time to treatment failure for PS of 0-1 was 88 weeks and for PS of 2-3 was 31 weeks.

Topics: Age Factors; Aged; Alkaline Phosphatase; Analysis of Variance; Antineoplastic Agents; Buserelin; Goserelin; Health Status; Humans; Male; Multivariate Analysis; Neoplasm Staging; Pain; Predictive Value of Tests; Proportional Hazards Models; Prostatic Neoplasms; Remission Induction; Testosterone

The LHRH analogue Zoladex was used to treat 21 premenopausal women with severe recurrent or refractory breast pain. Severity and pattern of mastalgia, whether cyclical or non-cyclical, was assessed using self-administered record cards. Symptom relief was achieved in 17 (81%) of the patients. This study showed Zoladex to be an effective short-term treatment for refractory and recurrent mastalgia.

Topics: Adult; Breast; Buserelin; Climacteric; Delayed-Action Preparations; Female; Goserelin; Humans; Middle Aged; Pain

A long-acting LRH agonist (ICI 118630, Zoladex) was given by monthly subcutaneous injection to 25 patients with previously untreated symptomatic advanced prostatic carcinoma. The medication was well tolerated with the only side effect being hot flushes in 15 patients. Subjective improvement occurred in 22 patients, and disease remission or stabilization judged by objective criteria was seen in 21 and 18 patients from the total group at 3 and 6 months of treatment, respectively. Twelve of 18 patients followed for 1 year were still in objective remission/stabilization. Prostate volume measured by ultrasound decreased by a mean value of 75% and urine flow increased significantly. There were significant falls in serum testosterone and gonadotrophin levels and significant although lesser reductions in serum androstenedione and dehydroepiandrosterone. These changes were accompanied by significant reductions in serum acid and alkaline phosphatase and a rise in serum osteocalcin. Four patients (16%) experienced an initial tumor flare. Although only a small number of patients were studied, Zoladex appeared to be a well-tolerated agent for treatment of prostatic carcinoma, with an initial clinical response similar to that seen with standard endocrine therapy.

Topics: Adult; Aged; Aged, 80 and over; Buserelin; Delayed-Action Preparations; Gonadal Steroid Hormones; Gonadotropin-Releasing Hormone; Goserelin; Humans; Male; Middle Aged; Pain; Prostatic Neoplasms; Ultrasonography

Fifty-six patients with previously untreated advanced prostatic cancer were treated with the LH-RH agonist Zoladex. Patients have been followed for between 24 and 39 months. The response rate and duration of response have been assessed and related to the degree of differentiation of the primary tumor. All of the patients with well-differentiated tumors responded symptomatically, while the comparable figure for patients with poorly differentiated tumors was 67%. The better differentiated tumors tended to respond longer than their poorly differentiated counterparts (18.75 months compared to 15.9 months, respectively). Overall survival was worse in patients having tumors of higher grade and the mean survival after relapse was shorter. The results confirm the unfavorable prognostic significance of poor histological grade in prostatic cancer and indicate that response to treatment, duration of response, and time to death following relapse are also adversely influenced.

Topics: Buserelin; Follow-Up Studies; Goserelin; Humans; Male; Neoplasms, Hormone-Dependent; Pain; Prognosis; Prostatic Neoplasms; Testosterone; Time Factors

9 of 12 patients with advanced metastatic carcinoma of the prostate treated with luteinising-hormone-releasing-hormone (LHRH) analogue ICI 118630 for a mean period of 6 months showed objective evidence of response to treatment. Of 8 patients with bone pain, 7 obtained relief. After 6 weeks of treatment testosterone concentrations were reduced to castrate levels (range less than 2 to 5.5 nmol/l) from a pretreatment mean value of 15.7 nmol/l (range 10.3-24 nmol/l). Basal gonadotropin levels and gonadotropin responses to acute LHRH stimulation were suppressed within 2 weeks of treatment. However, the testosterone response to stimulation with human chorionic gonadotropin was unimpaired 4 weeks after the start of treatment. Therefore suppression of the basal testosterone concentration by ICI 118630 was due to inhibition of pituitary luteinising-hormone secretion rather than direct inhibition of testicular Leydig-cell function. ICI 118630 offers an alternative treatment to orchidectomy and oestrogen therapy.

Topics: Acid Phosphatase; Aged; Bone Neoplasms; Chorionic Gonadotropin; Depression, Chemical; Gonadotropin-Releasing Hormone; Goserelin; Humans; Lymphatic Metastasis; Male; Middle Aged; Pain; Pelvis; Prostatic Neoplasms; Radiography; Testosterone