title: Desogestrel versus danazol as preoperative treatment for hysteroscopic surgery: a prospective, randomized evaluation.
abstract: The aim of this single-center, prospective, randomized, parallel-group study was to compare desogestrel and danazol as preoperative endometrial preparation for hysteroscopic surgery. We enrolled 200 consecutive eligible patients, in reproductive age, with endouterine diseases. Pre- and post-treatment characterization of endometrium was performed by hysteroscopic visual observation and histologic confirmation. The enrolled patients were randomly assigned to two groups: 100 were treated with 75 μg of desogestrel/die, 100 with 100 mg of danazol/die, both orally for 5 weeks, starting on Day 1 of menstruation. We recorded intraoperative data (cervical dilatation time, operative time, infusion volume and severity of bleeding) and drugs' side effects. Post-treatment comparison of endometrial patterns showed a significant more marked effect of desogestrel, respect to danazol, in atrophying endometrium ("normotrophic non-responders" versus "hypotrophic"-"atrophic", p = 0.031). Intraoperative data showed no significant differences between the two groups for cervical dilatation time (p = 0.160), while in the desogestrel group we found a significant reduction of operative time (p = 0.020), infusion volume (p = 0.012), and severity of bleeding (p = 0.004). Moreover, desogestrel caused less side effects (p = 0.031). According to our data analysis, desogestrel showed most marked effect in inducing endometrial atrophy, allowed a better intraoperative management and caused less side effects during treatment.
authors.affiliation: Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University of Messina , Messina , Italy.
authors.forename: Antonio Simone
authors.initials: AS
authors.lastname: Laganà
authors.forename: Vittorio
authors.initials: V
authors.lastname: Palmara
authors.forename: Roberta
authors.initials: R
authors.lastname: Granese
authors.forename: Leonarda
authors.initials: L
authors.lastname: Ciancimino
authors.forename: Benito
authors.initials: B
authors.lastname: Chiofalo
authors.forename: Onofrio
authors.initials: O
authors.lastname: Triolo
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D003613:Danazol / Q000494:pharmacology / Q000627:therapeutic use*; D017135:Desogestrel / Q000494:pharmacology / Q000627:therapeutic use*; D004717:Endometrium / Q000187:drug effects / Q000601:surgery; D004965:Estrogen Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D011372:Progestins / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery*
chemical_list: D004965:Estrogen Antagonists; D011372:Progestins; D017135:Desogestrel; D003613:Danazol
keywords: Danazol; desogestrel; hysteroscopic surgery; preoperative treatment; side effects