Abstract
Objective
To compare the usefulness of vaginal danazol and diphereline in the management of
intra-operative bleeding during hysteroscopy.
Design
Randomized controlled clinical trial.
Setting
University hospital.
Patients
One hundred and ninety participants of reproductive age were enrolled for operative
hysteroscopy. Thirty women were excluded from the study.
Interventions
One hundred and sixty participants with submucous myomas were allocated at random
to receive either vaginal danazol (200 mg BID, 30 days before surgery) or intramuscular diphereline (twice with a 28-day
interval).
Main outcome measures
Severity of intra-operative bleeding, clarity of the visual field, volume of media,
operative time, success rate for completion of operation and postoperative complications.
Results
Overall, 145 patients completed the study. In the danazol group, 78.1% of patients
experienced no intra-operative uterine bleeding, and 21.9% experienced mild bleeding.
In the diphereline group, 19.4% of patients experienced no intra-operative uterine
bleeding, but mild, moderate and severe bleeding was observed in 31.9%, 45.8% and
2.8% of patients, respectively. The difference between the groups was significant
(p < 0.001). A clear visual field was reported more frequently in the danazol group compared
with the diphereline group (98.6% vs 29.2%, p < 0.001). The mean operative time was 10.9 min and 10.6 min in the danazol and diphereline groups, respectively (p = 0.79). The mean volume of infused media was 2.0 L in both groups (p = 0.99). The success rate was 100% for both groups with no intra-operative complications.
Conclusion
Both vaginal danazol and diphereline were effective in controlling uterine bleeding
during operative hysteroscopy. However, vaginal danazol provided a clearer visual
field.
Keywords
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Article info
Publication history
Published online: November 26, 2015
Accepted:
October 28,
2015
Received in revised form:
October 20,
2015
Received:
May 12,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
