title: Comparative study of vaginal danazol vs diphereline (a synthetic GnRH agonist) in the control of bleeding during hysteroscopic myomectomy in women with abnormal uterine bleeding: a randomized controlled clinical trial.
abstract: OBJECTIVE
  To compare the usefulness of vaginal danazol and diphereline in the management of intra-operative bleeding during hysteroscopy.
  
  
  METHODS
  Randomized controlled clinical trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred and ninety participants of reproductive age were enrolled for operative hysteroscopy. Thirty women were excluded from the study.
  
  
  METHODS
  One hundred and sixty participants with submucous myomas were allocated at random to receive either vaginal danazol (200mg BID, 30 days before surgery) or intramuscular diphereline (twice with a 28-day interval).
  
  
  METHODS
  Severity of intra-operative bleeding, clarity of the visual field, volume of media, operative time, success rate for completion of operation and postoperative complications.
  
  
  RESULTS
  Overall, 145 patients completed the study. In the danazol group, 78.1% of patients experienced no intra-operative uterine bleeding, and 21.9% experienced mild bleeding. In the diphereline group, 19.4% of patients experienced no intra-operative uterine bleeding, but mild, moderate and severe bleeding was observed in 31.9%, 45.8% and 2.8% of patients, respectively. The difference between the groups was significant (p<0.001). A clear visual field was reported more frequently in the danazol group compared with the diphereline group (98.6% vs 29.2%, p<0.001). The mean operative time was 10.9 min and 10.6 min in the danazol and diphereline groups, respectively (p=0.79). The mean volume of infused media was 2.0L in both groups (p=0.99). The success rate was 100% for both groups with no intra-operative complications.
  
  
  CONCLUSIONS
  Both vaginal danazol and diphereline were effective in controlling uterine bleeding during operative hysteroscopy. However, vaginal danazol provided a clearer visual field.
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: Manizheh.sayyahmelli@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Sayyah-Melli
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Bidadi
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Taghavi
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: E
authors.initials: E
authors.lastname: Ouladsahebmadarek
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Jafari-Shobeiri
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Ghojazadeh
authors.affiliation: Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: V
authors.initials: V
authors.lastname: Rahmani
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D003613:Danazol / Q000627:therapeutic use*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D008875:Middle Aged; D011398:Promethazine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000601:surgery*; D063186:Uterine Myomectomy / Q000009:adverse effects*
chemical_list: D011398:Promethazine; D003613:Danazol
keywords: Danazol; Gonadotropin-releasing hormone agonist; Hysteroscopy; Uterine bleeding