Goserelin acetate (Zoladex) plus endometrial ablation for dysfunctional uterine bleeding: a large randomized, double-blind study

Jacques Donnez, J. Donnez, G Vilos, George A. Vilos, Michael Gannon, M J Gannon, S Stampe-Sorensen, Søren Stampe-Sorensen, I Klinte, Ingemar Klinte, R M Miller, Robert M. Miller
Fertility and sterility · 1997 · vol. 68(1) , pp. 29–36 · doi:10.1016/s0015-0282(97)81471-9 · PMID:9207580 · W2088231091
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This randomized, double-blind study investigated the efficacy of goserelin acetate combined with endometrial ablation for treating dysfunctional uterine bleeding.

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Abstract

OBJECTIVE: To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Multicenter, prospective, randomized, double-blind study. PATIENT(S): Cycling premenopausal women with dysfunctional uterine bleeding. TREATMENT: Patients were randomized to goserelin or placebo (sham depot) once monthly for 2 months prior to endometrial ablation. Treatment was timed to allow surgery 6 weeks later on day 7 of the menstrual cycle. MAIN OUTCOME MEASURE(S): Amenorrhea rates, endometrial histology and thickness, pain and blood loss scores, and surgical parameters. RESULT(S): At 24 weeks after surgery, significantly more goserelin than placebo patients experienced amenorrhea (40% versus 26%). Blood loss was reduced from baseline, but not different between the groups. At surgery, mean endometrial thickness was 1.6 mm and 3.4 mm for the goserelin and placebo groups, respectively, with significantly more atrophic glands and stroma in the goserelin group. Surgery was significantly shorter (by 22%) and easier in the goserelin than in the placebo group, with a significantly lower median fluid absorption in the goserelin groups. In both groups, pain scores were reduced patient satisfaction was high (> 92%), and re-intervention rate was low (2.8%). CONCLUSION(S): Goserelin in combination with endometrial ablation was superior to endometrial ablation alone for the treatment of dysfunctional uterine bleeding.

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MeSH descriptors

Antineoplastic Agents, Hormonal Endometrium Goserelin Uterine Hemorrhage Adult Antineoplastic Agents, Hormonal Double-Blind Method Endometrium Endometrium Endometrium Female Follow-Up Studies Goserelin Humans Hysteroscopy Prospective Studies Time Factors Treatment Outcome Ultrasonography Uterine Hemorrhage

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