Danazol versus a gonadotropin-releasing hormone agonist as preoperative preparation for hysteroscopic metroplasty

Objective: To compare the efficacy of danazol and a GnRH agonist as preoperative preparation for hysteroscopic metroplasty in women with septate uterus. Design: Prospective randomized clinical study. Setting: Tertiary care center. Patients: Thirty patients with septate uterus. Interventions: The patients were randomized to treatment with danazol 600 mg/d for 2 to 4 weeks (n = 15) or with leuprolide acetate depot 3.75 mg for 2 months (n = 15) as preoperative therapy for hysteroscopic metroplasty. Main Outcome Measures: At the intervention the hysteroscopist evaluated difficulty in dilation of the cervical canal, presence of endometrial fragments, bleeding, difficulty in maneuvering the resectoscope, and operating time. Results: Both the treatments were well tolerated. Metroplasty was simpler overall in the danazol group and also faster in introducing the resectoscope through the cervical canal and maneuvering it in the uterine cavity were both easier. Bleeding was modest in both groups and the anatomic outcome of the operation was similar. Conclusion: Short preoperative preparation with danazol results in favorable operating conditions at limited costs with minimal side effects.