| Does Adjuvant Long-Acting Gestagen Therapy Improve the Outcome of Hysteroscopic Endometrial Resection in Women of Low-Resource Settings With Heavy Menstrual Bleeding? | |
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MedLine Citation:
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PMID: 23403087 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To test for the hypothesis of the beneficial effect of long-acting gestagens as an adjuvant postoperative therapy on the outcome of hysteroscopic transcervical endometrial resection (TCRE) in women of low-resource settings and suffering from ovulatory heavy menstrual bleeding (menorrhagia). DESIGN: Randomized controlled trial (Canadian Task Force classification I). SETTING: Low-resource tertiary care university hospital. PATIENTS: Seventy-one premenopausal women with established ovulatory menorrhagia. INTERVENTION: After randomization, 37 patients were treated with TCRE plus gestagen and 34 patients with TCRE alone. MEASUREMENTS AND MAIN RESULTS: Variations in menstrual patterns and bleeding scores, as well as amenorrhea and repeat surgery rates with treatment, were determined 1 year after resection. In those who continued to menstruate at 6 months, treatment with TCRE plus gestagen was associated with a significant reduction in the number of days bleeding from 7.2 to 3.4 (p ≤ .0001), increased cycle length from 24 to 30 (p = .02), a 60% reduction in dysmenorrhea score from 62 to 25 (p ≤ .0001), and a 60% reduction in premenstrual syndrome score from 55 to 22 (p = .04). Amenorrhea rates at 12 months in the TCRE plus gestagen and TCRE alone groups were 40% versus 26% (p = .02), with combined amenorrhea and hypomenorrhea rates of 75% versus 64% (p = .02), respectively. At 12 months, repeat surgery rates were higher in the TCRE alone group (21% vs 3%, p < .05). CONCLUSION: In a low-resource setting, the adjuvant postoperative long-acting gestagen therapy has proven to be superior in inducing amenorrhea after hysteroscopic TCRE. |
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Authors:
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Tarek Shokeir; Mouhamed Eid; El-Said Abdel-Hady |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-2-8 |
Journal Detail:
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Title: Journal of minimally invasive gynecology Volume: - ISSN: 1553-4669 ISO Abbreviation: J Minim Invasive Gynecol Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-2-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101235322 Medline TA: J Minim Invasive Gynecol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of OB/GYN, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt (all authors). Electronic address: tarekshokeir1@hotmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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