Goserelin Depot Treatment Before Endometrial Resection

Area of Science:

• Gynecology
• Reproductive Medicine
• Minimally Invasive Surgery

Background:

• Endometrial resection is a surgical procedure to treat abnormal uterine bleeding.
• Absorption of distention fluid during hysteroscopy can lead to complications and prolong surgery.
• Gonadotropin-releasing hormone agonists are used to suppress ovarian function and reduce endometrial thickness.

Purpose of the Study:

• To evaluate the efficacy of goserelin depot treatment prior to endometrial resection.
• To determine if goserelin reduces fluid absorption and operating time.
• To assess the impact on intraoperative difficulties and long-term bleeding patterns.

Main Methods:

• A randomized controlled trial involving 71 women with menorrhagia.
• Patients received either 8 weeks of goserelin depot or immediate surgery.
• Data collected included operating time, fluid deficit, intraoperative difficulties, and 12-month bleeding patterns.

Main Results:

• Goserelin treatment showed a trend towards reduced fluid absorption (142 ml difference) and operating time (1.8 min difference).
• In women with adenomyosis, goserelin significantly reduced fluid deficit (298 ml difference).
• Intraoperative difficulties were significantly lower in the goserelin group (p=0.02).
• At 12 months, goserelin group had higher amenorrhea (35%) and lower hypermenorrhea (0%) rates compared to controls (20% amenorrhea, 13% hypermenorrhea).

Conclusions:

• Goserelin administration before endometrial resection may facilitate surgery by reducing fluid absorption and improving intrauterine conditions, particularly in adenomyosis patients.
• The long-term effects on menstrual bleeding patterns were modest.
• Further research may explore optimal patient selection for this neoadjuvant therapy.