14951
document
GnRH agonist treatment before total laparoscopic hysterectomy for large uteri . STUDY OBJECTIVE To evaluate whether uterine shrinkage induced by gonadotropin-releasing hormone ( GnRH ) agonists in women with a large uterus ( > 14 wks ) may facilitate total laparoscopic hysterectomy . DESIGN Randomized , prospective study ( Canadian Task Force classification I ) . SETTING University-affiliated hospital . PATIENTS Sixty-two women with symptomatic uterine myomas ( size 16-20 wks ) . INTERVENTIONS Total laparoscopic hysterectomy for benign pathology . MEASUREMENTS AND MAIN RESULTS Before surgery , women were assigned , at a ratio of 1:1 by random selection , to receive injections of triptorelin depot 11.25 mg 3 months before surgery ( group A ) or no treatment ( group B ) . Uterine volume , mean operating time , uterine weight , drop in hemoglobin , intraoperative complications , conversions to laparotomy , and hospital stay were recorded . Triptorelin decreased uterine volume , calculated by ultrasonography , by 26.5 % in group A , whereas the volume remained unchanged in group B . Statistical differences were found between groups concerning uterine weight , operating time , and drop in hemoglobin level . Three patients in group B were converted to laparotomy because of uterine size . CONCLUSION In women with a large uterus , a 3-month preoperative course of GnRH may facilitate laparoscopic hysterectomy , decreasing uterine size , operating time , and blood loss .
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Intervention_Pharmacological
GnRH agonist
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Intervention_Pharmacological
gonadotropin-releasing hormone ( GnRH ) agonists
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Intervention_Surgical
Total laparoscopic hysterectomy for benign pathology
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Intervention_Pharmacological
triptorelin depot
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Intervention_Pharmacological
GnRH
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Outcome_Physical
Uterine volume
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Outcome_Other
mean operating time
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Outcome_Physical
uterine weight , drop in hemoglobin
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Outcome_Adverse-effects
intraoperative complications
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Outcome_Physical
conversions to laparotomy
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Outcome_Other
hospital stay
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Outcome_Physical
uterine volume
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Outcome_Physical
uterine weight
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Outcome_Other
operating time
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Outcome_Physical
drop in hemoglobin level .
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Participant_Sex
women
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Participant_Condition
large uterus ( > 14 wks )
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Participant_Sample-size
Sixty-two
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Participant_Sex
women
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Participant_Condition
symptomatic uterine myomas
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Participant_Sex
women
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Participant_Condition
large uterus