Vs. Rai et al., Is endometrial pre-treatment of value in improving the outcome of transcervical resection of the endometrium?, HUM REPR, 15(9), 2000, pp. 1989-1992
The aim of this study was to determine whether or not the use of medical pr
e-treatment of the endometrium improves the outcome of transcervical resect
ion of the endometrium with regards to long-term operative outcome, histolo
gical findings and patient satisfaction. A prospective randomized trial com
paring three endometrial pre-treatment agents (danazol, medroxyprogesterone
acetate or nafarelin) with no pre-treatment was conducted. The main outcom
e measures were: (i) thickness of the endometrium and myometrium resected;
(ii) histological stage of the endometrium at the time of operation; (iii)
the presence or absence of menses and (iv) patient satisfaction 1 year post
operatively. Of the three pre-treatments studied, danazol produced a lower
median endometrial thickness than the control, showed the greatest ability
to induce atrophy of the endometrial glands and stroma (not statistically s
ignificant) and produced the highest rate of amenorrhoea (not different to
the control). Danazol and nafarelin produced significantly lower median end
ometrial thickness than no pre-treatment. There were, however, no significa
nt differences in the rates of amenorrhoea in any of the pretreatment group
s compared with that in the control group. No improvement in clinical outco
me or patient satisfaction is conferred by the use of medical pre-treatment
s if transcervical resection of the endometrium is performed in the prolife
rative phase of the menstrual cycle.