leuprolide and Fibrosis

Thirty-four premenopausal women were randomized to receive 3.75 mg of leuprorelin acetate depot or placebo for 8 weeks before hysterectomy. Postoperatively, the myometrium was examined by two independent pathologists and the pathologic features were graded. Computer analysis was used to assess myometrial cellularity and arterial wall structure (on hematoxylin and eosin-stained sections) and vascularity (on sections immunostained for Factor VIII-related antigen). The cellularity of the gonadotrophin-releasing hormone agonist-treated myometrium was higher than the controls with less stromal edema. Focal myometrial hyalinization was present in a minority of cases, all in the gonadotrophin-releasing hormone agonist-treated cases. The arteries in the gonadotrophin-releasing hormone agonist-treated uteri underwent atrophy of the tunica media and had significantly more perivascular fibrosis. The number of vessels per 100 myocytes also was decreased. Hypoestrinism secondary to leuprorelin treatment leads to myocyte atrophy, decreased stromal edema, atrophy of the arcuate arteries, and decreased myometrial vascularity.

Topics: Arteries; Atrophy; Delayed-Action Preparations; Double-Blind Method; Edema; Estradiol; Female; Fibrosis; Humans; Leuprolide; Menopause; Models, Biological; Myometrium; Placebos; Stromal Cells

To determine the optimal approach to prevent adhesions comparing leuprolide acetate (GnRH-a), Interceed (oxidized regenerated cellulose; Johnson & Johnson Medical, Inc., New Brunswick, NJ), and a combination of leuprolide with Interceed in a rabbit uterine horn adhesion model.. Prospective, randomized, blinded study.. Certified animal care facility.. Twenty-eight sexually mature, female New Zealand White rabbits.. Animals were prospectively randomized (by number generator) to receive GnRH-a or saline. After 6 weeks, standard surgical manipulations were performed at three sites in each uterine horn by [1]. suture, [2]. unipolar cautery, and [3]. superficial abrasion. Interceed was applied over one randomly assigned uterine horn only. Six weeks after surgery, uterine adhesions were assessed visually, and tissue fibrosis was assessed by histology.. Presence or absence of adhesions and microscopic tissue fibrosis.. Gonadotropin-releasing hormone agonist significantly decreased adhesions, whereas Interceed alone did not reduce adhesions. However, GnRH agonist plus Interceed was the most effective measure to reduce tissue fibrosis.. Preoperative GnRH-a is more effective than Interceed in preventing surgical adhesions in the rabbit uterine horn. However, preoperative GnRH-a plus Interceed may provide optimal results in this animal model, because microscopic tissue fibrosis is minimized with this combination.

Topics: Animals; Cellulose, Oxidized; Disease Models, Animal; Drug Therapy, Combination; Female; Fibrosis; Gonadotropin-Releasing Hormone; Gynecologic Surgical Procedures; Leuprolide; Postoperative Complications; Preoperative Care; Prospective Studies; Rabbits; Random Allocation; Regression Analysis; Tissue Adhesions; Uterus

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Female; Fibrosis; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Leuprolide; Menopause; Middle Aged; Uterine Neoplasms