Desogestrel versus danazol as preoperative treatment for hysteroscopic surgery: A prospective, randomized evaluation

The aim of this single-center, prospective, randomized, parallel-group study was to compare desogestrel and danazol as preoperative endometrial preparation for hysteroscopic surgery. We enrolled 200 consecutive eligible patients, in reproductive age, with endouterine diseases. Pre- and post-treatment characterization of endometrium was performed by hysteroscopic visual observation and histologic confirmation. The enrolled patients were randomly assigned to two groups: 100 were treated with 75μg of desogestrel/die, 100 with 100mg of danazol/die, both orally for 5weeks, starting on Day 1 of menstruation. We recorded intraoperative data (cervical dilatation time, operative time, infusion volume and severity of bleeding) and drugs' side effects. Post-treatment comparison of endometrial patterns showed a significant more marked effect of desogestrel, respect to danazol, in atrophying endometrium ("normotrophic non-responders" versus "hypotrophic"-"atrophic", p=0.031). Intraoperative data showed no significant differences between the two groups for cervical dilatation time (p=0.160), while in the desogestrel group we found a significant reduction of operative time (p=0.020), infusion volume (p=0.012), and severity of bleeding (p=0.004). Moreover, desogestrel caused less side effects (p=0.031). According to our data analysis, desogestrel showed most marked effect in inducing endometrial atrophy, allowed a better intraoperative management and caused less side effects during treatment.