Risk of recurrent menorrhagia after hydrothermoablation: role of GnRH analogues neoadjuvant treatment in long-term successful rate

• Published in: Clinical and experimental obstetrics & gynecology 2014-01, Vol.41 (4), p.426-431
• Main Authors: Litta, P, Saccardi, C, Tommasi, L, Di Giuseppe, J, Delli Carpini, G, Ciavattini, A
• Format: Article
• Language: English
• Subjects: Adult; Chemotherapy, Adjuvant; Delayed-Action Preparations - administration & dosage; Endometrial Ablation Techniques - methods; Female; Gonadotropin-Releasing Hormone - analogs & derivatives; Humans; Hysteroscopy; Luteolytic Agents - administration & dosage; Menorrhagia - pathology; Menorrhagia - therapy; Middle Aged; Neoadjuvant Therapy; Pain Measurement; Prospective Studies; Recurrence; Treatment Outcome; Triptorelin Pamoate - administration & dosage; Uterus - pathology
• ISSN: 0390-6663
• DOI: 10.12891/ceog19372014

To evaluate the long-term effectiveness of presurgical therapy with GnRH analogues in patients who underwenthydrothermal endometrial ablation (HTA) for menorrhagia and assess the relationship between sonographically measured myometrium thickness and pelvic pain. A prospective randomized control study comparing 15 women (Group A) with presurgical subcutaneous triptorelin depot injection before HTA with controls (Group B, n = 15). Inclusion criteria were: recurrent menorrhagia, uterus length < 12 cm, no previous hormonal therapy for at least six month, and family plan completed. Student's t test was applied, as appropriate, to compare continuous variables. Proportion were compared with chi-squared. After 12 months of follow-up, Group A showed a significantly lower (0% vs 20%; p = 0.03) failure rate after hydrothermoablation than the Group B and a generally higher successful rate at 24 and 48 months. The discomfort, evaluated with VAS, showed a mean value of 47.6 +/- 15.9 +/- SD); 96.7% of women reported a mild-moderate postoperative pain. No perioperative and late complications were recorded. Presurgical treatment with GnRH analogues seems to improve long-term efficacy of HTA. Perioperative pelvic pain seems to not be affected by myometrium thickness.