GnRH agonist therapy before myomectomy or hysterectomy

Abstract

1Which of the following mechanism(s) is/are responsible for the reduction in myoma volume associated with gonadotropin-releasing hormone (GnRH) agonist treatment? areduction in serum estradiol levelsbvasoconstriction in intramyomatous vasculaturecreduction in insulin-like growth factor Idall of the above2The greatest reduction in uterine size associated with GnRH agonist treatment is seen within the first a6 weeks of treatmentb12 weeks of treatmentc24 weeks of treatmentd52 weeks of treatment3Which one of the following is the most commonly used regimen of GnRH agonist administration as a monthly intramuscular injection of leuprolide acetate? a1.88 mgb3.75 mgc7.5 mgd11.25 mg4Which of the following is/are common side effect(s) associated with GnRH agonist treatment? avaginal hemorrhagebosteoporosiscvasomotor symptomsdall of the above5After cessation of GnRH agonist therapy, uterine volume typically acontinues to decreasebremains unchangedcreturns to pretreatment size within 3 monthsdreturns to pretreatment size within 6 months6In randomized trials, the use of GnRH agonists before myomectomy has been shown to areduce intraoperative blood lossbfacilitate “shelling out” of the myomascreduce operating timedfacilitate vertical skin incision7In randomized trials, GnRH agonist treatment before hysterectomy has been shown to areduce intraoperative blood lossbreduce operating timecfacilitate vaginal hysterectomydall of the above8In randomized trials, pretreatment with GnRH agonists has been shown to areduce postoperative complications after myomectomybreduce duration of hospital stay after myomectomycreduce mortality rate for hysterectomydreduce duration of hospital stay after hysterectomy9Use of GnRH agonists before hysteroscopic myomectomy has been shown to areduce operating timebreduce blood losscreduce amount of distention medium requireddall of the above10A potential disadvantage of the use of GnRH agonists before surgical treatment of uterine myomas is aincreased risk of adhesion formationbincreased risk of myoma recurrencecincreased risk of infertilitydincreased risk of pelvic pain