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Updated: Jul 26, 2026

Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

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Decrease in symptoms, blood loss and uterine size with nafarelin acetate before abdominal hysterectomy: a

O Ylikorkala¹, A Tiitinen, S Hulkko

¹Helsinki University Central Hospital, Department of Obstetrics and Gynecology, Finland.

Human Reproduction (Oxford, England)

|June 1, 1995

Summary

Nafarelin nasal spray effectively reduced uterine volume and increased hemoglobin before hysterectomy. However, it did not improve surgical outcomes and caused more hot flushes compared to placebo.

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Published on: September 12, 2025

Area of Science:

Gynecology
Reproductive Medicine
Surgical Adjuncts

Background:

Uterine fibroids, menometrorrhagia, and pelvic pain are common gynecological conditions often requiring hysterectomy.
Pre-surgical optimization can improve patient outcomes and surgical feasibility.

Purpose of the Study:

To evaluate the efficacy and safety of nafarelin as a pre-surgical treatment before hysterectomy.
To assess the impact of nafarelin on uterine volume, hemoglobin levels, and surgical outcomes.

Main Methods:

A prospective, placebo-controlled trial involving 188 pre-menopausal women undergoing hysterectomy.
Participants received either nafarelin (200 micrograms twice daily nasal spray) or placebo for 3 months pre-surgery.
Data analyzed from 166 women (107 nafarelin, 59 placebo).

Main Results:

Nafarelin significantly reduced uterine volume by 23.7% and increased blood hemoglobin by 5.5 g/l.
Uteri treated with nafarelin were significantly lighter (255.5 g vs. 346.2 g).
No significant differences in operative duration or blood loss; hot flushes were more common with nafarelin (61% vs. 35%).

Conclusions:

Nafarelin is a potentially useful pre-surgical adjunct for hysterectomy, particularly for raising hemoglobin or reducing uterine size.
While it shrinks the uterus, it does not offer direct surgical advantages in terms of operative time or blood loss.
Potential side effects like hot flushes should be considered in treatment decisions.