Promestrieno pré-operatório para histeroscopia: um ensaio clínico randomizado

Abstract

Objective Intraoperative complications of hysteroscopy, such as the creation of a false passage, cervix dilatation failure and uterine perforation, may require suspension of the procedure. Some patients refuse a new procedure, which delays the diagnosis of a possible serious uterine pathology. For this reason, it is essential to develop strategies to increase the success rate of hysteroscopy. Some authors suggest the preoperative use of topical estrogen for postmenopausal patients. This strategy is widely used in clinical practice, but studies demonstrating its effectiveness are scarce. The aim of this study is to evaluate the effect of cervical preparation with promestriene on the incidence of complications in postmenopausal women undergoing surgical hysteroscopy. Methods This is a double-blind clinical trial with 37 postmenopausal patients undergoing surgical hysteroscopy. Participants used promestriene or placebo vaginally daily for 2 weeks and then twice a week for another 2 weeks until surgery. Results There were 2/14 (14,3%) participants with complications in the promestriene group and 4/23 (17,4%) in the placebo group (P = 0,593). The complications were difficult cervical dilation, cervical laceration, and vaginal laceration. Conclusion Cervical preparation with promestriene did not reduce intraoperative complications in postmenopausal patients undergoing surgical hysteroscopy.