title: A retrospective case-control study comparing hysteroscopic resection versus hormonal modulation in treating menstrual disorders due to isthmocele.
abstract: In a retrospective case-control study, we compared the effectiveness of hysteroscopic correction and hormonal treatment to improve symptoms [postmestrual abnormal uterine bleeding (PAUB), pelvic pain localized in suprapubic site] associated with isthmocele. Women (n = 39; mean age ± SD, 35 ± 4.1 years) were subdivided in Group A [patients (n = 19) subjected to hysteroscopic surgery (isthmoplasty)] and, Group B [women (n = 20) undergoing hormonal treatment consisting of one oral tablet containing 0.075  mg of Gestodene and 0.030 mg of Ethynylestradiol for 21 days, followed by 7 days of suspension]. Resolution and/or improvement of menstrual disorders; patients degree of satisfaction with the treatment were measured 3 months later, by office hysteroscopy (Grop A) or phone call. PAUB and pelvic pain resolution was achieved in all patients: Group A had significant lower numbers of days of menstrual bleeding (P < 0.001), prevalence of pelvic pain in the suprapubic area (P = 0.04) and, higher degree of satisfaction (P < 0.001) compared to Group B. In conclusion, resectoscopic surgery is a valid way to treat patients with symptoms of prolonged postmenstrual uterine bleeding caused by isthmocele. Data from this study also indicate that resectoscopy may be the first choice because it is minimally invasive and yields good therapeutic results.
authors.affiliation: Department of Pediatrics, Obstetrics & Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, Siena, Italy. florio@unisi.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Giampiero
authors.initials: G
authors.lastname: Gubbini
authors.forename: Elena
authors.initials: E
authors.lastname: Marra
authors.forename: Daniela
authors.initials: D
authors.lastname: Dores
authors.forename: Daniela
authors.initials: D
authors.lastname: Nascetti
authors.forename: Luca
authors.initials: L
authors.lastname: Bruni
authors.forename: Raffaele
authors.initials: R
authors.lastname: Battista
authors.forename: Irene
authors.initials: I
authors.lastname: Moncini
authors.forename: Marco
authors.initials: M
authors.lastname: Filippeschi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D015907:Hysteroscopy; D008599:Menstruation Disturbances / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery*; D009652:Norpregnenes / Q000008:administration & dosage / Q000627:therapeutic use; D011372:Progestins / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery
chemical_list: D004338:Drug Combinations; D006728:Hormones; D009652:Norpregnenes; D011372:Progestins; C033273:Gestodene; D004997:Ethinyl Estradiol