Endometrial preparation with estradiol plus dienogest (Qlaira) for office hysteroscopic polypectomy: randomized pilot study.
OBJECTIVE
To estimate the effectiveness of Qlaira for endometrial preparation in women undergoing hysteroscopic polypectomy in the office setting.


METHODS
Randomized clinical pilot study (Canadian Task Force classification II-2).


METHODS
Academic research environment.


METHODS
Seventy-four cycling women undergoing hysteroscopic polypectomy (polyp size <1.5 cm).


METHODS
Women were randomized to be operated on during the proliferative phase (cycle day 5-7) of a spontaneous cycle (group A) or after 9 to 11 days of Qlaira intake (group B). Polypectomy was performed by using forceps and bipolar electrodes when required.


RESULTS
The quality of visualization of the uterine cavity during the procedure (visual analog score [VAS] 0-5, bad to optimal), total surgeon satisfaction (VAS 0-5, very difficult to easy to perform), and total patient satisfaction (VAS 0-5, severe pain to no pain) were compared. Endometrial thickness before and at the end of the procedure was significantly less in women in group B. Mean duration of interventions was shorter in group B than in group A. In addition, vision quality, and surgeon and patient satisfaction rates were significantly higher in women in group B.


CONCLUSIONS
At 10 days before surgery, administration of Qlaira is effective for preparation of the endometrium for hysteroscopic polypectomy in the office setting. With preoperative administration of Qlaira, the surgical procedure can be performed more easily and faster, and both surgeon and patient satisfaction rates are improved.
Department of Obstetrics and Gynecology, University of Bari, Bari, Italy. cicinelli@gynecology1.uniba.it
Ettore
E
Cicinelli
Vincenzo
V
Pinto
Paola
P
Quattromini
Maria Rosa
MR
Fucci
Achiropita
A
Lepera
Paola Carmela
PC
Mitola
Maria Vittoria
MV
Cicinelli
Fusco
F
Annarita
Raffaele
R
Tinelli
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods; D004717:Endometrium / Q000601:surgery; D004958:Estradiol / Q000627:therapeutic use*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008597:Menstrual Cycle; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017060:Patient Satisfaction; D010865:Pilot Projects; D011127:Polyps / Q000601:surgery*; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery*
D004967:Estrogens; D006727:Hormone Antagonists; C023635:dienogest; D004958:Estradiol; D009277:Nandrolone