A placebo-controlled trial of a depot gonadotropin-releasing hormone analogue (leuprolide) in the treatment of uterine leiomyomata

Article Abstract:

Fibroids (leiomyomata) in the uterus are common occurrences, and they are associated with pelvic discomfort, pain, increased menstrual flow, and infertility. Although their causes are unknown, treatment with drugs that reduce the levels of female hormones appears to reduce uterine size (enlarged as a result of fibroids). To learn more about the effects of one such agent, the drug leuprolide (Lupron, a gonadotropin-releasing hormone analogue) was evaluated for its ability to shrink fibroids in 11 women. Administration of this drug causes a reduction in the numbers of certain hormone receptors in the pituitary (the "master" endocrine gland), leading to a reduction in the levels of circulating female hormones. Patients were randomly assigned to either a control group (six patients) or a treatment group (five patients) at the start of the study; the treatment group received leuprolide, while the controls received saline (a placebo). Twenty-four weeks later, the control patients were switched to leuprolide; all patients then continued taking this drug for an additional 24 weeks. Evaluation of the drug's effectiveness was done by measuring uterine tissue with magnetic resonance imaging (MRI, a noninvasive method of viewing the body's organs). Results showed that treatment with leuprolide led to significant reductions in total uterine volume and in the volume of uterine tissue not occupied by the fibroid. During the saline control period, these values increased considerably (by 44 and 65 percent, respectively). Total fibroid volume was reduced as well, but not to a statistically significant degree, while on leuprolide. Patients' symptoms disappeared, for the most part, with leuprolide treatment. The results indicate that gonadotropin-releasing hormone analogues are effective in treating uterine leiomyomata. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Magnetic resonance imaging, Uterus, Leuprolide, Uterine fibroids, Hysterosonography, Lupron (Medication)

---

The efficacy of presacral neurectomy for the relief of midline dysmenorrhea

Article Abstract:

Painful menstruation, dysmenorrhea, can be caused by endometriosis, a painful condition where the endometrial cells normally lining the inside the uterus dislodge, implant and function in other areas of the body. The surgical technique known as presacral neurectomy, removal of a part of the nerve supplying the uterus, can relieve the pelvic pain associated with endometriosis. The efficacy of presacral neurectomy for the treatment of pelvic pain caused by endometriosis is reported. Twenty-six patients were diagnosed with severe endometriosis (stage II-IV); 17 underwent presacral neurectomy in addition to the conservative removal of endometrial tissue, and nine had the endometrial resection alone. The location of the pain on the sides (lateral pain) or down the center (midline pain) was assessed before and after surgery. At the six-month follow-up the pain reappeared in two women having the presacral neurectomy. None of the women who had the endometrial tissue resection alone experienced any midline pain relief. The pain experienced laterally, in the back and during intercourse varied in each group. None of the patients receiving the presacral neurectomy experienced any significant complications. It is likely that the two women who did not achieve pain relief were not good candidates for surgery or had an incomplete surgical resection. Presacral neurectomy is a highly effective treatment for intractable pain caused by endometriosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Surgery, Pain, Nerves, Dysmenorrhea

---

Megestrol acetate for treatment of endometriosis

Article Abstract:

Endometriosis, a condition in which small bits of uterine lining are abnormally located in the pelvic cavity or on the abdominal wall, is associated with pelvic pain, pain during menstruation, and pain during intercourse. Although it can be treated effectively by several hormonal agents, all drugs currently in use have significant side effects and can therefore only be used for relatively short periods. A report from preliminary trials using megestrol acetate (Megace) to treat 29 women with endometriosis is provided. The women in this study group had undergone previous treatments with hormones or anti-inflammatory agents without achieving satisfactory results. They took megestrol acetate for 2 to 24 months, and effectiveness was determined by patients' reports of their symptoms. Eighteen of the 21 women (86 percent) who took megestrol acetate for at least two months reported relief. However, 8 women discontinued the drug after 2 months and an additional 2 women stopped by 4 months. Side effects were common but, for the most part, tolerated. Breakthrough bleeding was reported by 41 percent of the women. Four of the six women who experienced fluid retention discontinued megestrol by two months. It appears that megestrol acetate may be effective for treating endometriosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Product/Service Evaluation, Megace (Medication)

Similar abstracts:

• Abstracts: A controlled trial of cyclosporine in the treatment of primary biliary cirrhosis. Efficacy of liver transplantation in patients with primary biliary cirrhosis
• Abstracts: Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing's syndrome
• Abstracts: A randomized, controlled trial of interferon alfa-2b alone and after prednisone withdrawal for the treatment of chronic hepatitis B
• Abstracts: A phase I/II trial of zidovudine, interferon-alpha, and granulocyte-macrophage colony-stimulating factor in the treatment of human immunodeficiency virus type I infection
• Abstracts: Peritoneal carcinomatosis of unknown primary site in women. The role of etoposide in the treatment of poorly differentiated carcinoma of unknown primary site

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.