子宮内膜ポリープに対する術前ジエノゲスト投与による子宮内腔の変化と子宮鏡下手術について

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  • Preoperative dienogest administration facilitates accurate hysteroscopic resection of endometrial polyps by altering the endometrium.

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Objective: Endometrial polyp is defined as an endometrial hyperplastic tumor, usually found in young and sometimes in peri-menopausal women, which can induce conditions such as abortions, irregular bleeding, and irregular periods due to hormonal instability. 'Dienogest' is a synthetic progestin which exerts a suppressive effect on follicular and ovarian functions. Due to its effects, endometrial cells become smaller and atrophic. For the purpose of achieving complete polypectomy, we administered this medication for preparation of the uterine cavity prior to hysteroscopic resection.<BR>Designs and Methods: We report herein 14 women with uterine cavity tumors. All 14 women gave informed consent prior to treatment with dienogest, starting at the nearest menstrual period before surgery. The women took 2 mg of dienogest orally starting the first day of the last menstrual period, continuously until the day before surgery. We observed the entire endometrium in the uterine cavity and the endoscopically-detected polyp was removed. We compared women who received dienogest with non-treated women.<BR>Results: We endoscopically identified a polyp due to atrophy of the surrounding endometrium, facilitating accurate resection of endometrial polypoid tissues. Furthermore, we were able to identify other small endometrial polyp, which could also be resected. <BR>Conclusion: By using dienogest preoperatively, we confirmed that a better visual field can be endoscopically acquired in the uterine cavity than in non-treated women. Furthermore, endometrial polypoid tissues can be accurately and easily resected, confirming that dienogest enhances operative quality. Preoperative dienogest administration is useful for hysteroscopic resection of endometrial polyps.

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