Desogestrel versus danazol as preoperative treatment for hysteroscopic surgery: a prospective, randomized evaluation

Antonio Simone Laganà, Vittorio Palmara, Roberta Granese, Leonarda Ciancimino, Benito Chiofalo, Onofrio Triolo
In: Gynecological Endocrinology · 2014 · vol. 30(11) , pp. 794–797 · doi:10.3109/09513590.2014.929658 · PMID:24919887 · W2058884822
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Desogestrel significantly reduced operative time, infusion volume, and bleeding during hysteroscopic surgery compared to danazol, while also inducing greater endometrial atrophy and fewer side effects.

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Abstract

The aim of this single-center, prospective, randomized, parallel-group study was to compare desogestrel and danazol as preoperative endometrial preparation for hysteroscopic surgery. We enrolled 200 consecutive eligible patients, in reproductive age, with endouterine diseases. Pre- and post-treatment characterization of endometrium was performed by hysteroscopic visual observation and histologic confirmation. The enrolled patients were randomly assigned to two groups: 100 were treated with 75 μg of desogestrel/die, 100 with 100 mg of danazol/die, both orally for 5 weeks, starting on Day 1 of menstruation. We recorded intraoperative data (cervical dilatation time, operative time, infusion volume and severity of bleeding) and drugs' side effects. Post-treatment comparison of endometrial patterns showed a significant more marked effect of desogestrel, respect to danazol, in atrophying endometrium ("normotrophic non-responders" versus "hypotrophic"-"atrophic", p = 0.031). Intraoperative data showed no significant differences between the two groups for cervical dilatation time (p = 0.160), while in the desogestrel group we found a significant reduction of operative time (p = 0.020), infusion volume (p = 0.012), and severity of bleeding (p = 0.004). Moreover, desogestrel caused less side effects (p = 0.031). According to our data analysis, desogestrel showed most marked effect in inducing endometrial atrophy, allowed a better intraoperative management and caused less side effects during treatment.

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