A randomized trial evaluating leuprolide acetate before hysterectomy as treatment for leiomyomas

Leiomyomas are benign (noncancerous) tumors that grow in smooth muscle tissue. When leiomyomas occur in the uterus, a hysterectomy (removal of the uterus) is performed to remove these tumors. The uterus can be removed through an incision made in the abdomen (abdominal hysterectomy) or by an incision made in the vagina (vaginal hysterectomy). Abdominal hysterectomies require a longer period of hospitalization, more blood transfusions, and give rise to more complications than vaginal hysterectomies. However, vaginal hysterectomies are difficult to perform if the uterus is large, and when leiomyomas grow in the uterus they increase the size of the uterus. Previous studies have reported that treatment with a drug that mimics the effect of gonadotropin-releasing hormone, such as leuprolide, can reduce the size of the uterus within eight weeks. A study was performed to determine if treatment with leuprolide would reduce the size of the uterus of women with leiomyomas, thereby making vaginal hysterectomy possible. Twenty-five women with leiomyomas were treated with leuprolide for two months, and 25 patients who were not treated were included for comparison. Treatment with leuprolide reduced the size of the uterus by 33 percent, and made it possible for 76 percent of the treated women to have vaginal hysterectomies. Only 16 percent of the women who were not treated were able to have vaginal hysterectomies. Those who received drug treatment spent an average of four days in the hospital, while those who were not treated spent an average of five days in the hospital. It is concluded that two months of treatment with leuprolide may allow patients with leiomyomas to be candidates for vaginal hysterectomy. (Consumer Summary produced by Reliance Medical Information, Inc.)