Study the effect of a single dose long acting progesterone in prevention of post hysterectomy functional ovarian cysts

Abstract

Background: Approximately 600,000 hysterectomies are performed annually in the United States, and more than one-third of women have had a hysterectomy by age 60 years. The most common diagnoses among women undergoing hysterectomy are uterine leiomyomata, adenomyosis, uterine prolapse and cancer or hyperplasia.Functional cysts may be single or multiple, may be bilateral and vary in size but generally do not exceed 5.0 cm in diameter. They are the result of failure of absorption of the fluid in an incompletely developed follicle or anovulation. They are usually asymptomatic unless hemorrhage, rupture or torsion supervenes, in which case symptoms and signs of acute abdomen develop. A progestogen-only injectable contraceptive is a long-acting, reversible contraceptive. A synthetic progesterone, or progestogen, is slowly released into the systemic circulation following intramuscular (IM) or subcutaneous (SC) injection. Methods: The study included 68 cases who were subjected to open hysterectomy without oophorectomy for benign gynecologic conditions, cases are randomly selected and divided into 2 groups. Group A: 34 cases received a single dose of 150 mg intramuscular depot medroxyprogesterone acetate as Depoprovera® within 7 to 10 days postoperative and Group B: 34 cases did not receive any medications. A post operative follow up was done every one month for six months postoperative to exclude the development of ovarian cyst by transvaginal and trans-abdominal ultrasound examination. Result: the statistical analysis of the collected data showed a statistical significance regarding the development of ovarian cysts in the control group. Conclusion: Single dose long acting progesterone after hysterectomy without oophorectomy is beneficial in prevention of development of simple functional ovarian cysts in women with hormonally active ovaries.