trelstar and Leiomyomatosis

To ascertain whether uterine shrinkage induced by a gonadotrophin releasing hormone agonist before hysterectomy for fibroids increases the possibility of a vaginal procedure.. A multicentre, prospective, randomised, controlled study.. One hundred and twenty-seven premenopausal women with a uterine volume of 12 to 16 gestational weeks.. Twelve weeks of triptorelin depot treatment before hysterectomy or immediate surgery.. Number of vaginal and abdominal hysterectomies, operating time, blood loss, degree of difficulty of the procedure, perioperative serum haemoglobin and haematocrit levels, hospital stay, and patients' overall satisfaction with treatment.. After randomisation, four women withdrew from the study, leaving 60 women in the triptorelin arm and 63 in the immediate surgery arm. At baseline evaluation a vaginal hysterectomy was indicated in seven women allocated to pre-operative medical therapy (12%), and in 10 of those allocated to immediate surgery (16%). Clinical assessment after the 12-week GnRH agonist course showed that abdominal hysterectomy was no longer indicated in 25/53 women (47%) as a vaginal procedure appeared appropriate. Thus the overall rate of indication for a vaginal procedure in the pre-operative medical treatment arm was 32/60 cases (53%), with a between-group difference of 37% (95% CI, 26% to 51%; chi2(1) = 19.18, P < 0.0001; OR 6.06; 95% CI, 2.60 to 14.10). Pre- and post-operative serum haemoglobin and haematocrit levels were significantly higher in the GnRH agonist than in the immediate surgery arm. No appreciable difference was observed between the groups in the other intra- and post-operative variables, including patients' satisfaction.. Pre-operative GnRH agonist therapy increased the rate of vaginal hysterectomy in selected women with fibroids and uterine volume of 12 to 16 gestational weeks.

Topics: Adult; Antineoplastic Agents, Hormonal; Combined Modality Therapy; Delayed-Action Preparations; Female; Humans; Hysterectomy; Leiomyomatosis; Middle Aged; Prospective Studies; Treatment Outcome; Triptorelin Pamoate; Ultrasonography; Uterine Neoplasms

To investigate the clinical characteristics of uterine myomas with cytogenetic rearrangements.. Comparative study of myomas with normal and abnormal karyotype.. University hospital.. Premenopausal, GnRH-agonist (GnRH-a) treated and menopausal patients.. Myomectomy or hysterectomy.. Karyotype analysis and clinical characteristics.. Clonal abnormalities occurred in 29% of uterine myomas but were not related to the age of the patient or, in untreated menopausal patients, to the size of the myoma. In GnRH-a treated and menopausal women, 48% of the myomas larger than 4 cm were associated with clonal abnormalities. Submucous myomas had significantly fewer clonal abnormalities (12%) than subserosal (29%) or intramural myomas (35%).. The data support the hypothesis that cytogenetic rearrangements in uterine myomas are associated with loss of steroid hormones dependency and alter the growth potential of the tumor.

Topics: Adult; Age Factors; Aged; Antineoplastic Agents, Hormonal; Chromosome Aberrations; Chromosome Disorders; Cohort Studies; Female; Humans; Karyotyping; Leiomyomatosis; Middle Aged; Prevalence; Retrospective Studies; Triptorelin Pamoate; Uterine Neoplasms

The results of hormonal examinations, measurements of dimensions of the uterus and leiomyomas, body weight, and also frequency of incurred climacteric signs in patients treated with Decapeptyl Depot 3.75 mg for three months are reported. Subjects consisted of 12 women, among whom nine were treated for leiomyomas and four for endometriosis (one patient also had leiomyomas). Based on examinations carried out, the biggest decrease of the uterus and leiomyomas was 13-17% observed just after two doses of analog, though after the end of treatment the dimensions of the uterus slowly increased. Therefore, 2-month therapy could be used successfully as preparation for further conservative surgical treatment. Significant increase of body weight in treated patients was not observed. In women with endometriosis pain symptoms in the hypogastric area and dyspareunia regressed during treatment and at the end were not observed. The disadvantages of therapy with Decapeptyl Depot 3.75 was the rapid occurrence of symptoms--climacteric signs, especially hot flashes--which were badly tolerated by patients. All these symptoms almost totally regressed one month after ending therapy.

Topics: Adult; Antineoplastic Agents, Hormonal; Body Weight; Delayed-Action Preparations; Endometriosis; Female; Humans; Leiomyomatosis; Middle Aged; Triptorelin Pamoate; Uterine Diseases; Uterine Neoplasms