title: The use of an oral contraceptive containing estradiol valerate and dienogest before office operative hysteroscopy: a feasibility study.
abstract: To investigate the impact of a 3 months preoperative administration of an oral contraceptive, containing dienogest (DNG) and estradiol valerate (E₂V) on the outcome of office operative hysteroscopy (OOH). One-hundred and forty-two patients diagnosed at office hysteroscopy as having an asynchronous endometrium associated with either a broad-base sessile endometrial polyp (>1.5, <2.5 cm) or a uterine septum (>1/3 uterine cavity) or scheduled for tubal sterilization were enrolled into a prospective case-control study at University "Federico II" of Naples. 86/142 patients accepted the preoperative hormonal treatment (Group A), while 56/142 refused, thus becoming controls (Group B). Group A underwent OOH during the 10th-20th days of the third cycle of treatment. In Group B OOH was performed at enrolment, together with the diagnostic procedure. The study outcomes were: endometrial pattern, success rate, operating time, degree of surgical difficulty and pain score. An overall improvement of the endometrium was reported in 100% of cases in Group A. A statistically significant difference in success rate could not be demonstrated between two groups. Operative procedures were performed significantly quicker and easier in Group A than Group B (p < 0.001 and p < 0.05, respectively). The mean Visual Analog Scale (VAS) score was significantly lower in Group A (p < 0.001). A short pretreatment with combined oral contraceptive (COC) containing E₂V/DNG seems to have a favorable impact on endometrium which in turn may result in an improvement of the overall outcomes of OOH.
authors.affiliation: Department of Obstetrics and Gynecology and Pathophisiology of Human Reproduction, University of Naples, Federico II, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bifulco
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Spiezio Sardo
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Rosa
authors.forename: Elena
authors.initials: E
authors.lastname: Greco
authors.forename: Marialuigia
authors.initials: M
authors.lastname: Spinelli
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Tommaselli
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D016889:Endometrial Neoplasms / Q000601:surgery; D004717:Endometrium / Q000187:drug effects*; D004958:Estradiol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D009277:Nandrolone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061646:Operative Time; D010044:Outpatient Clinics, Hospital; D010149:Postoperative Pain / Q000517:prevention & control*; D010865:Pilot Projects; D011127:Polyps / Q000601:surgery; D011300:Preoperative Care / Q000009:adverse effects; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000009:adverse effects; D014599:Uterus / Q000002:abnormalities / Q000601:surgery
chemical_list: D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; C454300:estradiol valerate-dienogest; D004958:Estradiol; D009277:Nandrolone