Management of uterine fibroids with goserelin acetate alone or goserelin acetate plus endometrial resection

Objectives To determine the extent of fibroid regrowth and the need for additional interventions following treatment with either goserelin alone or goserelin plus endometrial resection in women with fibroids. Design An open, randomized controlled trial with two treatment arms. Setting Women's Centre,John Radcliffe Hospital, Oxford, UK Subjects Women with fibroids whose uterine size exceeded 12 weeks of gestation (255-345 ml), but was less than 16 weeks' gestation (425-575 ml). Interventions Goserelin acetate alone and goserelin acetate plus endometrial resection. Main outcome measures Extent of fibroid regrowth and need for additional medical and surgical interventions over 12 months. Results There were fewer medical and surgical interventions in the women randomly allocated to goserelin and endometrial resection than in the goserelin-alone group (8.3% and 33%, respectively). Conclusions These results suggest that goserelin allows the use of endometrial resection in patients with fibroids, who would otherwise have been treated by hysterectomy.