Impact of Progesterone Therapy on Treatment Outcomes and Recurrence After Hysteroscopic Polypectomy.

BACKGROUND: One of the concerns after transcervical resection of endometrial polyps (TCRP) is the recurrence of polyps post-surgery. Some studies have shown that hormone therapy with progesterone may reduce the risk of recurrence. This clinical trial aimed to investigate the effect of progesterone treatment after hysteroscopic polypectomy. METHODOLOGY: In this clinical trial, 40 patients diagnosed with endometrial polyps were randomly and equally assigned to two groups: intervention and control. TCRP surgery was performed for both groups. In the intervention group, medroxyprogesterone was administered one week after surgery at a dose of 10 mg twice daily from the 5th day of the menstrual cycle for 21 days, over four cycles. The recurrence rate at 3 and 6 months post-surgery, endometrial thickness, hemoglobin levels, and menstrual status before and six months after surgery were compared between the two groups. RESULTS: None of the patients had a recurrence of endometrial polyps in the first three months, while three patients in the control group had a recurrence six months post-surgery (Relative Risk (RR) = 7.0, CI: 0.38-12.73). Regarding menstrual disorders, one patient in the control group had a menstrual disorder in the first three months (RR = 3.0, CI: 0.12-69.51), while six months post-surgery, 11 patients in the control group and one patient in the intervention group had menstrual disorders (RR = 11.55, CI: 1.63-81.45). Endometrial thickness six months post-surgery was significantly lower in the intervention group (5.5 ± 1.2 mm vs. 8.0 ± 2.5 mm, P = 0.001). The mean hemoglobin level six months post-surgery was higher in the intervention group, but it was not statistically significant. CONCLUSION: Progesterone administration after TCRP surgery may be effective due to improved menstrual status, reduced endometrial thickness, and possibly lower recurrence rates of endometrial polyps.