Efficacy of lntranasal Buserelin for Preoperative Treatment of Uterine Leiomyomas

Abstract

Objective To study the efficacy of intranasal buserelin for preoperative treatment of
uterine leiomyomas.
Design Open non-comparative study.
Setting Reproductiveendocrineunit,Ramathibodihospital.
Subjects Seventeen patients with symptomatic uterine leiomyomas.
lnterventions All patients were treated with intranasal buserelin 900 ug/day for 12-16
weeks. Hysterectomy was performed within 2 weeks after discontinuation of
buserelin treatment.
Main outcome measures Clinical symptoms, volume of uterine leiomyomas and adverse
effects of the treatment.
Resutts Two patients were excluded from the study, one had severe headache four
days after drug used, the other was lost to lollow up with unknown reason. The
mean volume of uterine leiomyoma decreased by 33% after 12 weeks of treatment
from mean pretreatment volume ol 274.94 t 37.45 cm3 to 182.46 t 16.78 cm3
(P < 0.05). Nine of fifteen patients experienced more than 25% reduction in leiomyoma
volume. Tumour related symptoms (dysmenorrhea, pelvic pain and pressure
symptoms) decreased in all cases after 8 weeks of treatrnent.
Conclusion This preliminary results demonstrate the efficacy of intranasal buserelin in
reduction of uterine leiomyoma and alleviation of clinical symptoms. The usefulness
and cost-benefit of GnRH-a preoperative treatment of uterine leiomyoma should
be evaluated further.