Thinning the endometrium prior to ablation: is it worthwhile?

Sutton, Christopher; Ewen, Simon P.

doi:10.1111/j.1471-0528.1994.tb13678.x

Cited by 40 publications

(37 citation statements)

References 7 publications

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“…Thinning of the endometrium reduced operative time and irrigant deficit significantly compared to cases not thus treated. This is in agreement with previous findings [19,20]. No severe (!120 mmol/l) hyponatremia was measured.…”

Section: Discussionsupporting

confidence: 83%

Experience with Isotonic 2.2% Glycine as Distension Medium for Hysteroscopic Endomyometrial Resection

Tapper

Heinonen²

1999

Gynecol Obstet Invest

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The feasibility of performing hysteroscopic endomyometrial resection using isotonic 2.2% glycine as distension medium was studied in 181 consecutive operations. A standard continuous flow loop-resectoscope was used. Distension was achieved by means of a gravity-fed system and glycine flowed out under its own pressure. The mean (±SEM) glycine deficit was 160 ± 20 ml and in only 7 patients was it >1 liter (maximum 1,800 ml). Only in patients with >1 liter glycine absorption was there a significant decrease in serum sodium level (mean 9 mmol/l), while serum osmolality remained normal. Apart from 1 case of transient nausea, these patients had no sequelae. We experienced isotonic 2.2% glycine as a useful and safe distending medium for operative hysteroscopy.

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Section: Discussionsupporting

confidence: 83%

Experience with Isotonic 2.2% Glycine as Distension Medium for Hysteroscopic Endomyometrial Resection

Tapper

Heinonen²

1999

Gynecol Obstet Invest

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“…Because of their hypoestrogenic effects, GnRH agonists given for a period of around 8 weeks have been found to be very effective in achieving the desired endometrial thinning before the procedure. [38]…”

Section: Uses Of Gonadotropin-releasing Hormone Analogues: Expanding mentioning

confidence: 99%

Gonadotropin releasing hormone agonists: Expanding vistas

Magon

2011

Indian J Endocr Metab

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Gonadotropin-releasing hormone (GnRH) agonists are derived from native GnRH by amino acid substitution which yields the agonist resistant to degradation and increases its half-life. The hypogonadotropic hypogonadal state produced by GnRH agonists has been often dubbed as “pseudomenopause” or “medical oophorectomy,” which are both misnomers. GnRH analogues (GnRH-a) work by temporarily “switching off” the ovaries. Ovaries can be “switched off” for the therapy and therapeutic trial of many conditions which include but are not limited to subfertility, endometriosis, adenomyosis, uterine leiomyomas, precocious puberty, premenstrual dysphoric disorder, chronic pelvic pain, or the prevention of menstrual bleeding in special clinical situations. Rapidly expanding vistas of usage of GnRH agonists encompass use in sex reassignment of male to female transsexuals, management of final height in cases of congenital adrenal hyperplasia, and preserving ovarian function in women undergoing cytotoxic chemotherapy. Hypogonadic side effects caused by the use of GnRH agonists can be tackled with use of “add-back” therapy. Goserelin, leuprolide, and nafarelin are commonly used in clinical practice. GnRH-a have provided us a powerful therapeutic approach to the treatment of numerous conditions in reproductive medicine. Recent synthesis of GnRH antagonists with a better tolerability profile may open new avenues for both research and clinical applications. All stakeholders who are partners in women's healthcare need to join hands to spread awareness so that these drugs can be used to realize their full potential.

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“…Because of their hypoestrogenic effects, GnRH agonists in usual doses administered for approximately 8 weeks have been found to be very effective in achieving the desired endometrial thinning before the procedure. [22] Once again, this prolonged use is expensive.…”

Section: Antagonist Protocolsmentioning

confidence: 99%

Gonadotropin-releasing hormone analogs: Understanding advantages and limitations

Kumar¹,

Sharma²

2014

J Hum Reprod Sci

122

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Pituitary stimulation with pulsatile gonadotropin-releasing hormone (GnRH) analogs induces both follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Pituitary gonadotropin secretions are blocked upon desensitization when a continuous GnRH stimulus is provided by means of an agonist or when the pituitary receptors are occupied with a competitive antagonist. GnRH antagonists were not available originally; therefore, prolonged daily injections of agonist with its desensitizing effect were used. Today, single- and multiple-dose injectable antagonists are also available to block the LH surge and thus to cause desensitization. This review provides an overview of the use of GnRH analogs which is potent therapeutic agents that are considerably useful in a variety of clinical indications from the past to the future with some limitations. These indications include management of endometriosis, uterine leiomyomas, hirsutism, dysfunctional uterine bleeding, premenstrual syndrome, assisted reproduction, and some hormone-dependent tumours, other than ovulation induction.

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Thinning the endometrium prior to ablation: is it worthwhile?

Cited by 40 publications

References 7 publications

Experience with Isotonic 2.2% Glycine as Distension Medium for Hysteroscopic Endomyometrial Resection

Experience with Isotonic 2.2% Glycine as Distension Medium for Hysteroscopic Endomyometrial Resection

Gonadotropin releasing hormone agonists: Expanding vistas

Gonadotropin-releasing hormone analogs: Understanding advantages and limitations

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