title: Efficacy of dienogest in thinning the endometrium before hysteroscopic surgery.
abstract: OBJECTIVE
  To investigate the efficacy of administration of dienogest to thin the endometrium before hysteroscopic surgery and to evaluate the surgical outcome.
  
  
  METHODS
  Retrospective clinical study (Canadian Task Force classification III).
  
  
  METHODS
  Community hospital.
  
  
  METHODS
  Twenty-six patients who underwent hysteroscopic surgery for treatment of endometrial polyps or submucous myomas <25 mm.
  
  
  METHODS
  Before hysteroscopic surgery, 13 patients (dienogest group) received 2 mg dienogest orally for 2 weeks, and 13 patients (GnRH group) received a gonadotropin-releasing hormone agonist subcutaneously 1 to 3 times every 4 weeks, and 4 of those received hormone therapy after surgery. Endometrial thickness, serum estradiol and progesterone concentrations, duration of surgery, weight of tissue removed, surgical field visualization, and time to resumption of spontaneous menstruation were recorded.
  
  
  RESULTS
  Endometrial thickness decreased from approximately 7.0 mm to 3.9 mm in the dienogest group. Duration of surgery and weight of tissue removed were similar between groups. The surgical field was clearly visualized in 12 patients in each group. Spontaneous menstruation resumed at approximately 22.0 days after hysteroscopic surgery in the dienogest group; in contrast, no resumption of spontaneous menstruation was observed within the first postoperative month in the GnRH group. No patients had perioperative complications, and none exhibited any residual tumor.
  
  
  CONCLUSIONS
  Administration of dienogest for 2 weeks thinned the endometrium and yielded favorable surgical outcomes, similar to those with GnRH agonists. Administration of dienogest may be an effective and convenient treatment before hysteroscopy.
authors.affiliation: Department of Obstetrics and Gynecology, Nissay Hospital, Osaka, Japan. Electronic address: michikokodama51@gmail.com.
authors.forename: Michiko
authors.initials: M
authors.lastname: Kodama
authors.forename: Masayo
authors.initials: M
authors.lastname: Onoue
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Otsuka
authors.forename: Namiko
authors.initials: N
authors.lastname: Yada-Hashimoto
authors.forename: Noriatsu
authors.initials: N
authors.lastname: Saeki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kodama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wakasa
authors.forename: Takao
authors.initials: T
authors.lastname: Funato
mesh_terms: D000328:Adult; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology / Q000601:surgery; D005260:Female; D006727:Hormone Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D009214:Myoma / Q000473:pathology / Q000601:surgery; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011127:Polyps / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery
chemical_list: D006727:Hormone Antagonists; C023635:dienogest; D009277:Nandrolone
keywords: Dienogest; Hysteroscopy; Pretreatment; Thin endometrium