A randomised controlled study of goserelin as adjunctive therapy prior to surgery in the management of uterine fibroids

Context: Luteinising hormone analogues are being increasingly advocated in the management of common oestrogendependent gynaecological conditions, notably uterine fibroids, endometriosis and menorrhagia. Objective: The aim was to assess the effects of depot injections of goserelin (Zoladex®), a GnRH-agonist analogue, on the management of uterine fibroids. Patients and Methods: Forty female pre-menopausal patients aged between 26 and 50 years, with uterine sizes 12 to 26 weeks were enrolled in a randomised controlled study. One group was prospectively randomized to surgery (deferred for 0 to 4 months) and another to goserelin treatment for 3 months, followed by surgery. Patients were included if they had a diagnosis of benign uterine fibroids and an abdomino-pelvic mass greater than 12 weeks gestational size. Results: Uterine and fibroids volumes were reduced by a median value of 31.7% and 58.1% respectively for Zoladex patients compared with an increase of 3.3% and 0.6% in uterine and fibroid volumes in the surgery-only patients. The difference between the treatment groups for the absolute changes was statistically significant (P