Rapid endometrial preparation for hysteroscopic surgery with oral desogestrel plus vaginal raloxifene: a prospective, randomized pilot study.
OBJECTIVE
To evaluate the effects after 10 days of an original treatment combining oral progestins with vaginal raloxifene to maximize the antiproliferative effect on the endometrium.


METHODS
Prospective, randomized, clinical pilot study.


METHODS
Academic research environment.


METHODS
Ninety women with endometrial polyps.


METHODS
On day 1 of the subsequent menstrual cycle, patients were randomized to receive oral desogestrel (n = 30) for 10 days combined with a tablet of raloxifene (60 mg) per vaginam (group A); oral desogestrel at 60 mg/day (n = 30; group B); or oral danazol at 200 mg, three times a day (n = 30; group C).


METHODS
Ultrasound measurement of endometrial thickness on day 11 of both the pretreatment and treatment cycles, surgeon satisfaction (0 to 10, visual analogue scale), and side effects.


RESULTS
At the second evaluation, the mean percentage reduction in endometrial thickness in group A was statistically significantly greater than in the other groups. Surgeon satisfaction in terms of endometrial thinning was also greater with group A.


CONCLUSIONS
Oral desogestrel plus vaginal raloxifene provides a fast, low-cost, and satisfactory preparation of the endometrium for operative hysteroscopy.
Cicinelli
Ettore
E
Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it <cicinelli@gynecology1.uniba.it>
Pinto
Vincenzo
V
Tinelli
Raffaele
R
Saliani
Nicola
N
De Leo
Vincenzo
V
Cianci
Antonio
A
D000328:Adult; D003131:Combined Modality Therapy; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use; D017135:Desogestrel / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004717:Endometrium / Q000473:pathology*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008597:Menstrual Cycle; D010865:Pilot Projects; D011127:Polyps / Q000188:drug therapy* / Q000601:surgery*; D017697:Premenopause; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use*; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*
D003280:Contraceptives, Oral, Synthetic; D004965:Estrogen Antagonists; D020849:Raloxifene Hydrochloride; D017135:Desogestrel