Uterine fibroids, or leiomyomata, are common benign tumors in women, influenced by estrogen levels. They can be asymptomatic or present with symptoms like abnormal uterine bleeding, pelvic pain, and disturbances to adjacent organs. Fibroids are categorized by location: subserosal, intramural, and submucosal. Despite being estrogen-dependent, their exact pathophysiology remains unclear. Management includes medical treatments, minimally invasive procedures, and surgeries. Gonadotropin-releasing hormone (GnRH) agonists, used preoperatively, reduce fibroid volume, surgical time, and hospital stay but have side effects limiting their use.

Methods: This prospective comparative study examines the effectiveness of GnRH analogues in reducing intraoperative congestion and postoperative complications in 31 women undergoing hysteroscopic resection of submucous myomas. Participants were divided into two groups: 15 receiving preoperative GnRH therapy and 16 undergoing surgeries without prior treatment. Preoperative assessments included general and gynecologic history, physical examination, and urine pregnancy test. Surgical times, intraoperative, and postoperative complications were recorded, with pain assessed using the visual analogue scale (VAS).

Results: The mean age and parity of women in both groups were similar. Preoperative myoma size significantly decreased in the GnRH group compared to the control group (1.1± 0.4 cm vs. 2.3± 0.8 cm, p=0.015). The mean surgical time was significantly shorter in the GnRH group (30.9± 2.1 min vs. 38.8± 3.9 min, p=0.009). Postoperative VAS scores were lower in the GnRH group but not statistically significant (4.5 vs. 5.9, p=0.081). Postoperative complications included less pain and significantly less bleeding in the GnRH group (p<0.05).

Conclusion: Preoperative GnRH analogue treatment effectively reduces myoma size, surgical time, and postoperative bleeding in women undergoing hysteroscopic resection of submucous myomas. These findings support the use of GnRH analogues as a beneficial preoperative treatment to improve surgical outcomes and reduce complications.

Index Terms: Uterine fibroids, GnRH analogues, Hysteroscopic resection, Myoma reduction, Preoperative treatment