Gonadotropin-releasing hormone agonist pretreatment did not decrease postoperative adhesion formation after abdominal myomectomy in a randomized control trial

Charles C. Coddington, Daniel R. Grow, Mohamed S. Ahmed, James P. Toner, Elizabeth Cook, Michael Peter Diamond

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To determine if 3 months of preoperative gonadotropin-releasing hormone agonist (GnRH-a) treatment decreases postoperative uterine adhesions after open abdominal surgery for the removal of uterine fibroids. Design: Prospective, randomized, clinical study. Setting: A tertiary care medical center. Patient(s): Women of reproductive age with symptomatic uterine fibroids not amenable to hysteroscopic removal. Intervention(s): Twenty patients underwent an initial abdominal myomectomy followed by a second-look laparoscopy for evaluating uterine adhesions after random allocation to groups receiving either GnRH analog or placebo for 3 months before the initial surgery. Main Outcome Measure(s): Adhesion formation between treatment groups and by incision number and aggregate length. Result(s): Presurgical GnRH-a treatment did not decrease adhesion formation compared with placebo. For every additional centimeter of incision length, the total adhesion area over the uterine serosal surface increased by 0.55 cm2. The number of myomas removed and the number of incisions were positively correlated with total adhesion area. Conclusion(s): Preoperative treatment with GnRH-a for 3 months before open abdominal myomectomy did not decrease postoperative uterine adhesions. Following the standards of good surgical technique, adhesions are minimized with fewer and smaller incisions.

Original languageEnglish (US)
Pages (from-to)1909-1913
Number of pages5
JournalFertility and sterility
Volume91
Issue number5
DOIs
StatePublished - May 1 2009

Fingerprint

Uterine Myomectomy
Gonadotropin-Releasing Hormone
Leiomyoma
Placebos
Tissue Adhesions
Myoma
Therapeutics
Random Allocation
Tertiary Care Centers
Laparoscopy
Outcome Assessment (Health Care)

Keywords

  • Myoma
  • adhesion prevention
  • adhesions
  • fibroid
  • myomectomy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Gonadotropin-releasing hormone agonist pretreatment did not decrease postoperative adhesion formation after abdominal myomectomy in a randomized control trial. / Coddington, Charles C.; Grow, Daniel R.; Ahmed, Mohamed S.; Toner, James P.; Cook, Elizabeth; Diamond, Michael Peter.

In: Fertility and sterility, Vol. 91, No. 5, 01.05.2009, p. 1909-1913.

Research output: Contribution to journalArticle

Coddington, Charles C. ; Grow, Daniel R. ; Ahmed, Mohamed S. ; Toner, James P. ; Cook, Elizabeth ; Diamond, Michael Peter. / Gonadotropin-releasing hormone agonist pretreatment did not decrease postoperative adhesion formation after abdominal myomectomy in a randomized control trial. In: Fertility and sterility. 2009 ; Vol. 91, No. 5. pp. 1909-1913.
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