Differential efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment on pedunculated and degenerated myomas: a retrospective study of 630 women.

This study was designed to compare the anatomical location of myomas (submucous, intramural, subserous, or cervical), whether pedunculated or non-pedunculated if degenerated or undegenerated and relating these findings to myoma volume reduction in women treated with gonadotropin-releasing hormone agonist (GnRHa). Our retrospective study group included 630 patients with symptoms attributed to fibroids. They were treated with a single GnRH agonist for 20 weeks and the size of the myoma was monitored by magnetic resonance imaging and/or ultrasonographic scan. During a 20 week-treatment, submucous, intramural, or subserous fibroids showed an overall reduction of 63% (P<0.01) with little variation between these types. No reduction in size was seen in cases of pedunculated, degenerated, or cervical myomas. These data suggest that GnRH agonist therapy might be used primarily for non-pedunculated and undegenerated myomas.