Endometrial Preparation With Estradiol Plus Dienogest (Qlaira) for Office Hysteroscopic Polypectomy: Randomized Pilot Study

Ettore Cicinelli; Vincenzo Pinto; P. Quattromini; Maria Rosa Fucci; Achiropita Lepera; Paola Carmela Mitola; Maria Vittoria Cicinelli; Annarita Fusco; Raffaele Tinelli

doi:10.1016/j.jmig.2011.12.020

Endometrial Preparation With Estradiol Plus Dienogest (Qlaira) for Office Hysteroscopic Polypectomy: Randomized Pilot Study

Ettore Cicinelli, Vincenzo Pinto, P. Quattromini, Maria Rosa Fucci, Achiropita Lepera, Paola Carmela Mitola, Maria Vittoria Cicinelli, Annarita Fusco, Raffaele Tinelli

In: Journal of Minimally Invasive Gynecology · 2012 · vol. 19(3) , pp. 356–359 · doi:10.1016/j.jmig.2011.12.020 · PMID:22322156 · W2033096114

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This randomized pilot study investigated endometrial preparation with estradiol plus dienogest for office hysteroscopic polypectomy.

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Abstract

Study objectiveTo estimate the effectiveness of Qlaira for endometrial preparation in women undergoing hysteroscopic polypectomy in the office setting.DesignRandomized clinical pilot study (Canadian Task Force classification II-2).SettingAcademic research environment.PatientsSeventy-four cycling women undergoing hysteroscopic polypectomy (polyp size <1.5 cm).InterventionsWomen were randomized to be operated on during the proliferative phase (cycle day 5-7) of a spontaneous cycle (group A) or after 9 to 11 days of Qlaira intake (group B). Polypectomy was performed by using forceps and bipolar electrodes when required.Measurements and main resultsThe quality of visualization of the uterine cavity during the procedure (visual analog score [VAS] 0-5, bad to optimal), total surgeon satisfaction (VAS 0-5, very difficult to easy to perform), and total patient satisfaction (VAS 0-5, severe pain to no pain) were compared. Endometrial thickness before and at the end of the procedure was significantly less in women in group B. Mean duration of interventions was shorter in group B than in group A. In addition, vision quality, and surgeon and patient satisfaction rates were significantly higher in women in group B.ConclusionsAt 10 days before surgery, administration of Qlaira is effective for preparation of the endometrium for hysteroscopic polypectomy in the office setting. With preoperative administration of Qlaira, the surgical procedure can be performed more easily and faster, and both surgeon and patient satisfaction rates are improved.

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