Ultrasound evaluation of internal genitalia of girls with idiopathic central precocious puberty before and during treatment with GnRH analogs - Revista Brasileira de Ginecologia e Obstetrícia

Ultrasound evaluation of internal genitalia of girls with idiopathic central precocious puberty before and during treatment with GnRH analogs |

PURPOSE: to verify, through pelvic ultrasound, the existence of changes in the internal genitalia of girls with central precocious puberty, submitted to treatment with gonadotrophin-releasing hormone (GnRH) analogs. METHODS: pelvic ultrasound was performed in 18 girls with idiopathic central precocious puberty, before and after three months of onset of the treatment with GnRH analogs, to investigate the impact of the therapy on the internal genitalia. Ovarian and uterine volumes, uterine longitudinal length, relation between the longitudinal diameter of the uterine corpus and the uterine cervix, the relation between the anterior-posterior diameter of the uterine corpus and the uterine cervix, and endometrial echogenicity were evaluated. Statistical analysis was performed through Shapiro-Willkis's test, to assess data normality. When normality was present, Student's test t was applied. For data without normality, a non-parametric test (the signal test) was used. RESULTS: after therapy, statistically significant decline of the mean uterine volume (from 5.4 cm³ to 3.0 cm³, p<0.001), of the mean ovarian volume (from 2.2 cm³ to 1.1 cm³, p= 0.004), of the mean uterine longitudinal length (from 4.2cm to 3.4 cm, p=0.001), and of the mean endometrial echogenicity (from 1.8 mm to 0.6 mm, p=0.018) occurred. CONCLUSION: In girls with idiopathic central precocious puberty, pelvic ultrasound is a valid method to assess the efficacy of treatment with GnRH analogs. The main parameters of the therapeutic response were the decrease of uterine and ovarian volume, of uterine longitudinal length, and atrophy or absence of endometrial echogenicity.