Preoperative dienogest to improve the surgical field of view in resectoscopic surgery

Takehiko Tsuchiya, Yukiko Katagiri, Toshimitsu Maemura, Eijiro Hayata, Yusuke Fukuda, Mamoru Kitamura, Mineto Morita
In: Gynecology and Minimally Invasive Therapy · 2015 · vol. 5(1) , pp. 16–19 · doi:10.1016/j.gmit.2015.01.011 · W823587108
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Preoperative dienogest administration thinned the endometrium and improved the surgical field of view, minimizing endometrial damage during resectoscopic surgery for submucosal myomas and endometrial polyps.

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Abstract

Resectoscopic surgery requires high technological skill to perform the procedure in a limited field of vision. With the preoperative administration of dienogest, a good surgical field of vision can be secured. The lesion and the normal endometrium are easily distinguished, and therefore the removal of normal endometrium can be minimized. Preoperative dienogest was administered to 28 patients with submucosal myomas, 18 patients with endometrial polyps, and one patient with Asherman's syndrome. The patients began taking oral dienogest (2 mg/d) on Day 5 of preoperative menstruation until the day before surgery. Use of dienogest before resectoscopic surgery was approved by the Institutional Review Board of Toho Medical Center Oomori Hospital (Tokyo, Japan; approval number 24-185). The duration of oral dienogest treatment was 14–72 days in patients with submucosal myoma and 18–85 days in patients with endometrial polyps. Slight thickening of the endometrium occurred in patients who were administered dienogest for 14 days. However, a thin endometrium occurred in patients who took the drug for 28 days or longer. Submucosal myomas and endometrial polyps were easily distinguished from the normal myometrium. A sufficient intrauterine surgical field was secured to minimize endometrial damage in all patients. We found that preoperative dienogest effectively minimized endometrial damage in resectoscopic surgery by thinning the endometrium and clearing the surgical field of vision.

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