Efficacy of Dienogest in Thinning the Endometrium Before Hysteroscopic Surgery

Kodama, Michiko; Onoue, Masayo; Otsuka, Hiroyuki; Yada-Hashimoto, Namiko; Saeki, Noriatsu; Kodama, Tatsuhiko; Wakasa, T.; Funato, Takao

doi:10.1016/j.jmig.2013.04.020

Cited by 25 publications

(18 citation statements)

References 18 publications

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“…Thirteen patients received 2 mg DIE orally twice a day for a median of 14.0 days and 13 patients were administered a gonadotropin-releasing hormone agonist subcutaneously 1-3 times every 4 weeks before hysteroscopic surgery. Twelve patients in each group had both thinned and clearly visualized endometrium during surgery [11]. Similar to this study, Cicinelli et al [12] showed thinner and well-prepared endometrium before hysteroscopic polypectomy was performed in patients who were administered estradiol plus DIE.…”

Section: Discussionsupporting

confidence: 82%

“…In a recent study, Kodama et al [11] investigated the efficacy of the administration of DIE to thin the endometrium before hysteroscopic surgery and they also evaluated the outcome after surgery. There were 26 patients who had endometrial polyps or submucous myomas with an endometrium thickness diagnosed by ultrasound (maximum endometrial diameter was lesser than 25 mm).…”

Section: Discussionmentioning

confidence: 99%

“…Shimizu et al [9] has also concluded that DIE may be considered effective treatment for gynecological diseases associated with abnormal endometrial proinflammatory and proliferative activities [10]. In another study, Kodama et al [11] investigated the efficacy of DIE in thinning the endometrium before hysteroscopic surgery. They showed that the administration of DIE (2 mg orally in a day) for 2 weeks thinned the endometrium.…”

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confidence: 99%

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The Efficacy of Dienogest in the Treatment of Simple Endometrial Hyperplasia without Atypia

Uysal

Açmaz²,

Madendağ³

et al. 2017

Gynecol Obstet Invest

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Aim: The aim of the study was to compare the effectiveness of dienogest (DIE), depo medroxyprogesterone 17-acetate (MPA), and micronized progesteron (MP) regimens for treatment of simple endometrial hyperplasia (EH) without atypia. Methods: One hundred and twenty premenopausal patients aged between 35 and 55, with simple EH without atypia, were offered 3 types of progestins (MPA, MP, and DIE) and were randomized to one of them. After 6 months of treatment, patients were reevaluated. The efficacy of different progestins in treatment of EH was compared with regard to resolution and regression rates. We classified the terms of resolution and regression as “complete response” and persistence as “no response”. Results: A total of 99 patients continued the study (31 in MP, 35 in MPA, and 33 in the DIE group). None of the results of endometrial pathology were progressed to atypia or complex hyperplasia. The complete response resolution rate was 93.5% in the MP, 88.5% in the MPA, and 96.9% in the DIE group. The highest complete response rate was in the DIE group, although there was no statistically significant difference between groups (p = 0.39). The efficacy of progestins was similar between the groups. Conclusion: DIE is an effective and convenient method for thinning the endometrium.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The Efficacy of Dienogest in the Treatment of Simple Endometrial Hyperplasia without Atypia

Uysal

Açmaz²,

Madendağ³

et al. 2017

Gynecol Obstet Invest

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“…The impact of the MMI in patients undergoing OH for several interventions should be addressed in further studies. In addition, we did not use novel hormonal therapy agents, such as dienogest, which has been shown to improve endometrial thinning [33,34]. Implementation of such an agent could facilitate the hysteroscopy by offering a clearer view of the uterine cavity and therefore influence the patients' anxiety and the complication rate.…”

Section: Discussionmentioning

confidence: 99%

Use of video-based multimedia information to reduce anxiety before office hysteroscopy.

Akça¹,

Yılmaz²,

Esmer³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: Use of multimedia tools has been shown to improve patient comprehension, reduce pre-procedural anxiety, and increase patient satisfaction in various surgical settings. Aim: To investigate the impact of video-based multimedia information (MMI) on the anxiety levels of patients undergoing office hysteroscopy (OH). Material and methods: All consecutive women aged 18-65 years and scheduled for diagnostic OH were enrolled in this prospective randomized study. Subjects were assigned to receive video-based MMI or conventional written information (controls). The trait and state anxiety were assessed using the State and Trait Anxiety Inventory (STAI) before the MMI or written information. STAI-state (STAI-S) was repeated after application of the MMI or written information. All patients underwent a standardized transvaginal hysteroscopy procedure by the same gynecologist. Following the hysteroscopy, patient satisfaction and procedural pain were ranked using a Likert scale and visual analogue scale. Results: Fifty-two patients were randomized to receive a video-based MMI, and 52 patients were randomized to receive written information. Post-information STAI-S score was significantly lower in the MMI group than that of the written information group (45.0 ±8.0 vs. 49.4 ±8.4, p < 0.001, 95% CI for the difference: 1.36-7.79). Moreover, the satisfaction rate of the video group was significantly higher than the satisfaction rate of the controls (92.3% vs. 63.5%, p < 0.001). VAS score of procedural pain was similar for the two groups. Conclusions: A video-based MMI before OH might be preferred to conventional information methods in order to reduce the pre-procedural anxiety and to increase patients' satisfaction.

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“…It is important to remember this fact prior to schedule hysteroscopic surgery, sometimes the endometrial thickness is above 16 mm and it will diffi cult the correct visualization of the endometrial cavity and even will cause the suspension of the procedure. The solution can be either wait until we can check the endometrium's thickness with an ultrasound or to give a gestagene thinning the endometrium prior to the hysteroscopic procedure [ 29 ].…”

Section: Ulipristal Acetatementioning

confidence: 99%