• Isabela Maciel Caetano, Agnaldo Lopes da Silva Filho, Rivia Mara Lamaita, Bernardo Avila Maia, Eduardha Santos Temponi Barroso, and Eduardo Batista Candido.
• Universidade Federal de Minas Gerais, Hospital das Clínicas, Woman's Health Department - Belo Horizonte (MG), Brazil.
• Rev Assoc Med Bras (1992). 2024 Jan 1; 70 (6): e20231559e20231559.

ObjectiveIntraoperative 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 preoperative use of topical estrogen for postmenopausal patients. This strategy is common in clinical practice, but studies demonstrating its effectiveness are scarce. The aim of this study was to evaluate the effect of cervical preparation with promestriene on the incidence of complications in postmenopausal women undergoing surgical hysteroscopy.MethodsThis is a double-blind clinical trial involving 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.ResultsThere were 2 out of 14 (14.3%) participants with complications in the promestriene group and 4 out of 23 (17.4%) participants in the placebo group (p=0.593). The complications were difficult cervical dilation, cervical laceration, and vaginal laceration.ConclusionCervical preparation with promestriene did not reduce intraoperative complications in postmenopausal patients undergoing surgical hysteroscopy.

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