Mardanian Farahnaz, Mehrabian Ferdous, Rouholamin Safura, Izadpanahi Somayeh, Hashemi Maryam
Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Minimally Invasive Gynecologic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2024 Apr 27;13:32. doi: 10.4103/abr.abr_227_21. eCollection 2024.
Hysteroscopic surgery is a common gynecologic process in many conditions. Endometrial thinning is the main successful key for this process associated with many preoperative preparations. This study aimed to evaluate DE (Desogestrel-estradiol) to reduce endometrial thickness in comparison with the control group.
This Randomized clinical trial was done on the patients candidate for polypectomy that were randomly divided into two groups of intervention and control; the first group received DE OCP (oral contraceptive pill with 30 microgram Ethinyl estradiol + 150 micro gram Desogestrel) once daily from the 1 to 5 day of the menstrual cycle for 21 days and then in the first day of next menstruation cycle, the drug was used up to one day before hysteroscopy done in the 5 to 8 day of the cycle. The second group received no drugs. Hysteroscopy was done in the early follicular phase in both groups and all the subjects received one dosage of Misoprostol a night before surgery.
There were no significant differences between the parity, polyp size, and BMI (Body Mass Index) in the two groups. The mean duration of surgery, mean endometrial thickness before hysteroscopy, the quality of endometrial tissue, and surgeon satisfaction were significantly difference between the two groups. However, the quality of the surgeon's vision in the intervention group was better than the control group but there was no significant difference between the two groups.
Pre-operation endometrial thinning by oral contraceptives such as DE could be an effective method and reduce the duration of surgery.
宫腔镜手术在许多情况下是一种常见的妇科手术。子宫内膜变薄是该手术成功的关键，这与许多术前准备有关。本研究旨在评估去氧孕烯炔雌醇（Desogestrel-estradiol，DE）与对照组相比在减少子宫内膜厚度方面的效果。
本随机临床试验针对拟行息肉切除术的患者进行，将其随机分为干预组和对照组；第一组在月经周期的第1至5天每天服用一次DE口服避孕药（含30微克炔雌醇 + 150微克去氧孕烯），持续21天，然后在下一个月经周期的第一天，在周期的第5至8天宫腔镜检查前一天继续用药。第二组不服用药物。两组均在卵泡早期进行宫腔镜检查，所有受试者在手术前一晚服用一剂米索前列醇。
两组在产次、息肉大小和体重指数（Body Mass Index，BMI）方面无显著差异。两组之间手术的平均时长、宫腔镜检查前的平均子宫内膜厚度、子宫内膜组织质量和外科医生满意度存在显著差异。然而，干预组外科医生的视野质量优于对照组，但两组之间无显著差异。
使用DE等口服避孕药进行术前子宫内膜变薄可能是一种有效的方法，并可缩短手术时长。
