Nomegestrol acetate versus combined oral contraceptive as rapid endometrial preparation for operative hysteroscopy: a prospective randomised pilot study

Excerpt

Hysteroscopy is now the established “gold standard” for the assessment and treatment of intrauterine pathology such as fibroids, polyps, synechiae, septa and endometrial resection and/or destruction, and is regarded as a safe, acceptable and well-tolerated procedure [1‐5]. In fertile women, hysteroscopic procedures are best performed when the endometrium is thin because the operating time is lessened and fluid absorption decreases, making surgery easier [6‐9]. For these reasons, the days immediately after menstruation are the best period for hysteroscopy. Scheduling surgery during the early follicular phase is not always possible, so several drugs have been proposed to reduce endometrial thickness, intra-operative bleeding, surgical difficulties and duration of surgery [6, 10, 11]. Even if preoperative treatment with gonadotropin-releasing hormone analogues (GnRH-a) or danazol for 2 or 3 months has been recommended to remove large intramural sub-mucous myomas or perform endometrial resection [9], they are not as often used for procedure preparation especially in case of minor hysteroscopy. GnRH-a result in a state of temporary menopause and are expensive, while danazol induces unfavourable side effects including weight gain, growth of hair, acne and general malaise [12]. Several studies have reported that gestrinone also is capable of reducing uterine volume, menorrhagia and endometrial thickness [13‐15]. …