Endometrial preparation with estradiol plus dienogest (Qlaira) for office hysteroscopic polypectomy: randomized pilot study

Study Objective: To estimate the effectiveness of Qlaira for endometrial preparation in women undergoing hysteroscopic polypectomy in the office setting. Design: Randomized clinical pilot study (Canadian Task Force classification II-2). Setting: Academic research environment. Patients: Seventy-four cycling women undergoing hysteroscopic polypectomy (polyp size <1.5 cm). Interventions: Women were randomized to be operated on during the proliferative phase (cycle day 5-7) of a spontaneous cycle (group A) or after 9 to 11 days of Qlaira intake (group B). Polypectomy was performed by using forceps and bipolar electrodes when required. Measurements and Main Results: The quality of visualization of the uterine cavity during the procedure (visual analog score [VAS] 0-5, bad to optimal), total surgeon satisfaction (VAS 0-5, very difficult to easy to perform), and total patient satisfaction (VAS 0-5, severe pain to no pain) were compared. Endometrial thickness before and at the end of the procedure was significantly less in women in group B. Mean duration of interventions was shorter in group B than in group A. In addition, vision quality, and surgeon and patient satisfaction rates were significantly higher in women in group B. Conclusions: At 10 days before surgery, administration of Qlaira is effective for preparation of the endometrium for hysteroscopic polypectomy in the office setting. With preoperative administration of Qlaira, the surgical procedure can be performed more easily and faster, and both surgeon and patient satisfaction rates are improved