[Laparoscopic hysterectomy after GnRh analogue therapy]

The aim of this clinical prospective study was to evaluate the effectiveness of the GnRh analogues treatment carried out before the implementation of a laparoscopic hysterectomy on patients affected by fibromatosis and metrorrhagia.

We examined a cohort of 40 women sharing an average uterine volume of 510+/-95 cm3 observed in a time span of 22 months. Precociously, in the follicular phase we treated our sample of patients with only one ampoule of triptorelin 11.25 mg in a short-term regime. At the end of the treatment, after about 3 months, we re-scanned by ultrasound the uterine volume before carrying out the surgical treatment.

The presurgical treatment with GnRh analogues allowed a significant reduction of the uterine volume of about 4% in 34 cases (85% patients) as confirmed by ultrasound. The Student t test revealed significant difference before and after the treatment with a P value <0.05. Further, we obtained an increase of about 2-3 g of hemoglobin. The average treatment time was of about 130 min (ranging from 110 to 160 min). The only intrasurgical complication consisted in a vescical lesion which we repaired without consequences. In the postsurgical period we incurred in only 3 cases of fever (38.5 degrees C) which required an antibiotic therapy. The average length of hospitalization was three days.

The presurgical treatment with GnRh analogues can be considered a valuable option in the management of the uterine leiomyomas pathology.