Rapid endometrial preparation for hysteroscopic surgery with oral desogestrel plus vaginal raloxifene: a prospective, randomized pilot study

ObjectiveTo evaluate the effects after 10 days of an original treatment combining oral progestins with vaginal raloxifene to maximize the antiproliferative effect on the endometrium.DesignProspective, randomized, clinical pilot study.SettingAcademic research environment.Patient(s)Ninety women with endometrial polyps.Intervention(s)On day 1 of the subsequent menstrual cycle, patients were randomized to receive oral desogestrel (n = 30) for 10 days combined with a tablet of raloxifene (60 mg) per vaginam (group A); oral desogestrel at 60 mg/day (n = 30; group B); or oral danazol at 200 mg, three times a day (n = 30; group C).Main Outcome Measure(s)Ultrasound measurement of endometrial thickness on day 11 of both the pretreatment and treatment cycles, surgeon satisfaction (0 to 10, visual analogue scale), and side effects.Result(s)At the second evaluation, the mean percentage reduction in endometrial thickness in group A was statistically significantly greater than in the other groups. Surgeon satisfaction in terms of endometrial thinning was also greater with group A.Conclusion(s)Oral desogestrel plus vaginal raloxifene provides a fast, low-cost, and satisfactory preparation of the endometrium for operative hysteroscopy.