Comparison And Analysis Of The Efficacy Of Different Adjuvant Hormones After Removal Of Endometrial Polyps With Hysteroscopy

Objective:To study the effects of oral Drosirenone and Ethinylestradiol tablets and Dydrogesterone tablets on preventing the recurrence of endometrial polyps after hysteroscopic endometrial polypotomy respectively.Methods:A total of 120 patients who were diagnosed as endometrial polyp by hysteroscopy or transvaginal sonography were collected from December 2016 to December 2018.After TCRP,the patients with endometrial polyps were averagely divided into group A,B,C according to the postoperative treatment.In group A,40 patients were treated with Drosirenone and Ethinylestradiol tablets from the first day of menstruation,1 pill once a day for 21 days,and started taking the pills on the first day of the next mentrual cycle,6 cycles in all.In group B,40 patients were treated with Dydrogesterone tablets from the 11 th day of menstruation,1 pill twice a day for 15 days,and started taking the pills on the 11th day of the next mentrual cycle for 6 cycles.In group C,40 patients were not given any treatment after operation.All patients were followed up with the improvement of menstruation,endometrial thickness and the recurrence of endometrial polyps on the 6th and 12th month after the treatment.Results:The average of operation time is 21.43±1.96min,21.40±2.05min,and 21.65±2.10min,respectively.The average of intraoperative bleeding volumes is 10.85±1.72mL,10.65±1.64mL and 10.98±1.73mL,respectively.There was no significant difference in operation times and intraoperative bleeding volumes between the treatment groups and control group(P>0.05).The improvement rate of menstruation in group A,B,C at 6th month was 95.0%(38/40),92.5%(37/40),75.0%(30/40),respectively.The endometrial thickness in group A,B,C at 6th month was 5.4±0.74mm,5.5±1.10mm,6.2±1.37mm,respectively.The recurrence of endometrial polyps in group A,B,C at 6th month was 0,2.5%(1/40),15.0%(6/40),respectively.There were significant differences in the improvement of menstruation,endometrial thickness and the recurrence of endometrial polyps between the treatment groups and control group at 6th month(P<0.05).The improvement rate of menstruation in group A,B,C at 12th month was 92.5%(37/40),75.0%(30/40),52.5%(21/40),respectively.The endometrial thickness in group A,B,C at 12th month was 6.6±1.37mm,6.81±1.42mm,9.3±1.73mm,respectively.The recurrence of endometrial polyps in group A,B,C at 12th month was 2.5%(1/40),10.0%(4/40),35.0%(14/40),respectively.There were significant differences in the improvement of menstruation,endometrial thickness and the recurrence of endometrial polyps between the treatment groups and control group at 12th month(P<0.05).There was signicicant difference in the improvement of menstruation between the group A and group B(P<0.05).The rate of adverse reaction in group A and B was 2.5%(1/40),12.5%(5/40).There was no significant difference on the rate of adverse reaction between group A and group B.Conclusions:The 2 drugs assisted for endometrial polyps treatment after TCRP can significant improve the menstruation,reduce the thickness of the endometrium,and decrease the recurrence rate of endometrial polyps.Drosirenone and Ethinylestradiol tablets were better than Dydrogesterone tablets in improving menstruation.There was no significant difference on adverse reaction between the 2 drugs group(P>0.05).