ANALYSIS OF SINGLE DOSE GNRH ANALOG (GOSERELIN ACETATE - 10,8 MG) TREATMENT IN PATIENTS WITH UTERIN LEIOMYOMATOSIS TREATED AT THE OUTPATIENT CLINIC OF ENDOCRINE GYNECOLOGY OF A TERTIARY HOSPITAL IN CURITIBA

Abstract

Introduction: Leiomyomas are benign tumors that appear in the myometrium and are common in women of childbearing age. They may be asymptomatic or may be associated with pelvic symptoms, such as bleeding and pain. Objectives: In the present study, we analyzed clinical situations of 64 women with symptomatic uterine leiomyomatosis who underwent treatment with GnRH analogue (gonadotropin releasing hormone agonist) injection, these patients were followed up in 2009-2019. Data were collected from medical records of the Gynecology outpatient clinic of the Santa Casa Hospital in Curitiba. Method: It is an observational, retrospective study, with quantitative and qualitative variables. Inclusion criterias were women with ultrasound-proven uterine leiomyomatosis who underwent GnRH analogue treatment. Quantification of uterine volume reduction after GnRH application; assessment of improvement in hematimetric levels after analogue application; measurement and discrimination of how many patients underwent surgery and correlation with clinical history; the assessment of which surgery was most performed and the identification of complaints before and after injection correspond to the objectives found in the current study. Results: In fact, the use of preoperative GnRH analogue contributed to the improvement of hematimetric indices, in which an average increase of hemoglobin of 20.1% was observed, and pre-application contributed to a reduction of uterine volume by 90.6% of the patients. Thus, a safer surgical scenario was obtained for the 23 patients who required surgery, whether via abdominal, vaginal hysterectomy or even myomectomy. In line with the literary arsenal, this study noted that the main complaints – pre-application of the analogue – were abnormal uterine bleeding and dysmenorrhea; just as the complaint after injection was mainly the hot flush, that occurs due to the state of hypoestrogenism, caused by the GnRH. Conclusion: In light of this evidence, the GnRH analogue has numerous benefits as a therapeutic and preoperative treatment for uterine leiomyomatosis; its adverse effects and high cost, however, contribute to lower accessibility to patients.