Is endometrial pre-treatment of value in improving the outcome of transcervical resection of the endometrium?

Vikram Rai, V S Rai, M. D. G. Gillmer, M D Gillmer, Wendy N. Gray, W Gray
Human Reproduction · 2000 · vol. 15(9) , pp. 1989–1992 · doi:10.1093/humrep/15.9.1989 · PMID:10967001 · W2156867468
RCT OA: bronze CC0 ⤵ 16 in-corpus citations
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This trial found that endometrial pre-treatment with danazol or nafarelin reduced endometrial thickness, but no pre-treatment improved operative outcomes, histological findings, or patient satisfaction in transcervical resection.

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Abstract

The aim of this study was to determine whether or not the use of medical pre-treatment of the endometrium improves the outcome of transcervical resection of the endometrium with regards to long-term operative outcome, histological findings and patient satisfaction. A prospective randomized trial comparing three endometrial pre-treatment agents (danazol, medroxyprogesterone acetate or nafarelin) with no pre-treatment was conducted. The main outcome measures were: (i) thickness of the endometrium and myometrium resected; (ii) histological stage of the endometrium at the time of operation; (iii) the presence or absence of menses and (iv) patient satisfaction 1 year post-operatively. Of the three pre-treatments studied, danazol produced a lower median endometrial thickness than the control, showed the greatest ability to induce atrophy of the endometrial glands and stroma (not statistically significant) and produced the highest rate of amenorrhoea (not different to the control). Danazol and nafarelin produced significantly lower median endometrial thickness than no pre-treatment. There were, however, no significant differences in the rates of amenorrhoea in any of the pre-treatment groups compared with that in the control group. No improvement in clinical outcome or patient satisfaction is conferred by the use of medical pre-treatments if transcervical resection of the endometrium is performed in the proliferative phase of the menstrual cycle.

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MeSH descriptors

Endometrium Endometrium Estrogen Antagonists Hormones Premedication Treatment Outcome Amenorrhea Amenorrhea Danazol Danazol Endometrium Endometrium Estrogen Antagonists Female Hormones Humans Medroxyprogesterone Acetate Medroxyprogesterone Acetate Menorrhagia Menorrhagia

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