Calliope Fine

A randomized, double-blind trial of a gonadotropin releasing-hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri *

A randomized, double-blind study was performed on 16 women to compare the efficacy of daily subcutaneous (SC) injections of leuprolide acetate (LA; TAP Pharmaceuticals, North Chicago, IL) plus oral placebo tablets (group A, n = 7) with SC LA plus oral medroxyprogesterone acetate (The Upjohn Company, Kalamazoo, MI; group B, n = 9) in the treatment of leiomyomata uteri. Patients in group A had a significant reduction in uterine size from a pretreatment volume of 601 +/- 62 cm3 (mean +/- standard error) to a mean uterine volume of 294 +/- 46 cm3 at 24 weeks of therapy (P less than 0.01). Group B patients had a reduction in uterine volume from 811 +/- 174 cm3 to 688 +/- 154 cm3, which was not statistically significant. However, only one patient in group B experienced hot flashes, whereas six patients in group A had this symptom (P less than 0.01). Both groups demonstrated significant increases in mean hemoglobin concentrations, hematocrits, and serum iron levels at 24 weeks of therapy compared with pretreatment levels.

Sonographic Urethrogram: Comparison to Roentgenographic Techniques in 22 Patients

A sonographic technique was devised to examine the anterior urethra in 22 men suspected of having stricture disease. All patients underwent sonographic and roentgenographic urethrograms. Cystoscopic examination was done in 17 patients. The sonographic urethrogram findings were as diagnostic as the roentgen findings in 19 patients. In 1 patient the sonographic urethrogram identified a bulbar urethral stricture not seen on a retrograde urethrogram. In 2 patients a bulbar urethral sinus tract was found by the retrograde urethrogram but not by the sonographic urethrogram, although the remaining 2 sonographic urethrograms correctly identified the urethral pathological condition. Structures outside the lumen of the urethra including the urethral wall, corpus spongiosum, corpus cavernosum, bulb and external urinary sphincter were seen clearly by the sonographic urethrogram. The fossa navicularis can be visualized as well. Foreign bodies in the urethra, straddle injury and stricture disease were correctly diagnosed by the sonographic urethrogram. No patient reported discomfort during the examination. The sonographic urethrogram provided valuable information about the luminal and extraluminal anatomy of the anterior urethra. Further long-term studies will be necessary to assess its ultimate diagnostic potential.

Recurrence of myomas after myomectomy in women pretreated with leuprolide acetate depot or placebo

The recurrence of myomas and myoma-related symptoms was evaluated in women participating in a randomized, double-blind, P-controlled study of the efficacy of LA depot before myomectomy. After 27 to 38 months of follow-up, the recurrence of myomas was found to be greater when at least four myomas were resected. Myoma recurrence was not associated with pretreatment or preoperative uterine volume, resected myoma mass, or preoperative medical therapy.

A Randomized, Double-Blind Trial of a Gonadotropin-Releasing Hormone Agonist (Leuprolide) with or without Medroxyprogesterone Acetate in the Treatment of Leiomyomata Uteri

A randomized, double-blind study was performed on 16 women to compare the efficacy of daily subcutaneous (SC) injections of leuprolide acetate (LA; TAP Pharmaceuticals, North Chicago, IL) plus oral placebo tablets (group A, n = 7) with SC LA plus oral medroxyprogesterone acetate (The Upjohn Company, Kalamazoo, MI; group B, n = 9) in the treatment of leiomyomata uteri. Patients in group A had a significant reduction in uterine size from a pretreatment volume of 601 +/- 62 cm3 (mean +/- standard error) to a mean uterine volume of 294 +/- 46 cm3 at 24 weeks of therapy (P less than 0.01). Group B patients had a reduction in uterine volume from 811 +/- 174 cm3 to 688 +/- 154 cm3, which was not statistically significant. However, only one patient in group B experienced hot flashes, whereas six patients in group A had this symptom (P less than 0.01). Both groups demonstrated significant increases in mean hemoglobin concentrations, hematocrits, and serum iron levels at 24 weeks of therapy compared with pretreatment levels.