{"paper_id":"0d43422e-308d-4bbf-b440-d15a9a10cf4c","body_text":"Abstract\nOffice operative hysteroscopy is facilitated by endometrial preparation. In fact, with a thin endometrium the uterine cavity is wider and more explorable, intracavity abnormalities (polyps, myomas, etc.) are easily detectable and frequently smaller compared to previous evaluation. This implies that removal may be easier, operating time shorter, volume of distention media needed for the procedure lower, and therefore the procedure may be safer and better accepted by patients. The results of all this studies demonstrated that ten days of estradiol (E2) and Dienogest (Klaira) administration provides a rapid and effective endometrial suppression. A shorter time needed to obtain a satisfactory endometrial preparation improves both patient acceptability and working organization as it facilitates scheduling and avoids the need to postpone surgery by long period of time.\nSimilar content being viewed by others\nReferences\nGimpelson RJ, Whalen TR. Hysteroscopy as gold standard for evaluation of abnormal uterine bleeding. Am J Obstet Gynecol. 1995;173:1637–8.\nRai VS, Gillmer MDG, Gray W. Is endometrial pre-treatment of value in improving the outcome of transcervical resection of the endometrium? Hum Reprod. 2000;15:1989–92.\nParazzini F, Vercellini P, De Giorgi O, Pesole A, Ricci E, Crosignani PG. Efficacy of preoperative medical treatment in facilitating hysteroscopic endometrial resection, myomectomy and metroplasty: literature review. Hum Reprod. 1998;13:2592–7.\nVercellini P, Perino A, Consonni R, Trespidi L, Parazzini F, Crosignani PG. Treatment with a gonadotrophin releasing hormone agonist before endometrial resection: a multicentre, randomised controlled trial. BJOG. 1996;103:562–8.\nSowter MC, Lethaby A, Singla AA. Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding. Cochrane Database Syst Rev. 2002;3:CD001124.\nDonnez J, Vilos G, Gannon MJ, Stampe-Sorensen S, Klinte I, Miller RM, et al. Goserelin acetate (Zoladex) plus endometrial ablation for dysfunctional uterine bleeding: a large randomized, double-blind study. Fertil Steril. 1997;68:29–36.\nFedele L, Bianchi S, Gruft L, Bigatti G, Busacca M. Danazol versus a gonadotropin-releasing hormone agonist as preoperative preparation for hysteroscopic metroplasty. Fertil Steril. 1996;65:186–8.\nMarchini M, Fedele L, Bianchi S, Di Nola G, Nava S, Vercellini P. Endometrial patterns during therapy with gestrinone for endometriosis: structural and ultrastructural study. Hum Pathol. 1992;23:51–6.\nFlorio P, Imperatore A, Litta P, Franchini M, Calzolari S, Angioni S, Gabbanini M, Bruni L, Petraglia F. The use of nomegestrol acetate in rapid preparation of endometrium before operative hysteroscopy in pre-menopausal women. Steroids. 2010;75:912–7.\nGrow DR, Iromloo K. Oral contraceptives maintain a very thin endometrium before operative hysteroscopy. Fertil Steril. 2006;85:204–7.\nLaganà AS, Vitale SG, Muscia V, Rossetti P, Buscema M, Triolo O, Rapisarda AM, Giunta L, Palmara V, Granese R, Frangež HB, Romano A. Endometrial preparation with Dienogest before hysteroscopic surgery: a systematic review. Arch Gynecol Obstet. 2017;295(3):661–6676.\nLaganà AS, Palmara V, Granese R, Ciancimino L, Chiofalo B, Triolo O. Desogestrel versus danazol as preoperative treatment for hysteroscopic surgery: a prospective, randomized evaluation. Gynecol Endocrinol. 2014;30(11):794–7.\nCicinelli E, Pinto V, Tinelli R, Saliani N, De Leo V, Cianci A. Rapid endometrial preparation for hysteroscopic surgery with oral desogestrel plus vaginal raloxifene: a prospective, randomized pilot study. Fertil Steril. 2007;88(3):698–701.\nHaimovich S, Mancebo G, Alameda F, Agramunt S, Hernández JL, Carreras R. Endometrial preparation with desogestrel before Essure hysteroscopic sterilization: preliminary study. J Minim Invasive Gynecol. 2013;20(5):591–4.\nCicinelli E, Pinto V, Quattromini P, Fucci MR, Lepera A, Mitola PC, Cicinelli MV, Annarita F, Tinelli R. Endometrial preparation with estradiol plus Dienogest (Qlaira) for office hysteroscopic polypectomy: randomized pilot study. J Minim Invasive Gynecol. 2012;19:356–9.\nDotto JE, Lema B, Dotto JE Jr, Hamou J. Classification of microhysteroscopic images and their correlation with histologic diagnoses. J Am Assoc Gynecol Laparosc. 2003;10:233–46.\nShimizu Y, Takeuchi T, Mita S, Mizuguchi K, Kiyono T, Inoue M, Kyo S. Dienogest, a synthetic progestin, inhibits the proliferation of immortalized human endometrial epithelial cells with suppression of cyclin D1 gene expression. Mol Hum Reprod. 2009;15:693–701.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2018 Springer International Publishing AG\nAbout this chapter\nCite this chapter\nTinelli, R., Cicinelli, E. (2018). Endometrial Presurgical Preparation. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_46\nDownload citation\nDOI: https://doi.org/10.1007/978-3-319-57559-9_46\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-319-57558-2\nOnline ISBN: 978-3-319-57559-9\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}