Comparative Efficacy of Hysteroscopic Evacuation Versus Oral Estrogen‐Progestogen Therapy (Femoston) for Retained Products of Conception After Abortion: A Prospective Comparative Study

AIM: To compare the clinical efficacy and safety of hysteroscopic evacuation and oral estrogen-progestogen therapy (Femoston) in the management of retained products of conception (RPOC) after abortion. METHODS: This prospective comparative study enrolled 75 women with post-abortion RPOC. Participants were allocated to treatment according to informed preference: 38 received oral Femoston therapy, and 37 underwent hysteroscopic evacuation. Outcomes included duration of vaginal bleeding, time to resumption of menstruation, endometrial thickness after menstrual cleansing, treatment success, and adverse outcomes. RESULTS: Compared with the hysteroscopy group, the Femoston group had shorter vaginal bleeding duration and earlier resumption of menstruation. Endometrial thickness after menstrual cleansing was greater in the Femoston group. The Femoston group also had a lower overall rate of recorded adverse outcomes, including infection and adhesions. Both groups showed clinical improvement in intrauterine residual tissue, while hysteroscopic evacuation achieved a numerically higher immediate clearance rate. However, oral Femoston achieved a comparable overall clinical effect without invasive intervention. CONCLUSION: Both hysteroscopic evacuation and oral Femoston showed clinical benefit in the management of post-abortion RPOC. In selected clinically stable patients, oral Femoston may be a feasible conservative alternative, associated with shorter bleeding duration, earlier resumption of menses, greater endometrial thickness after treatment, and fewer recorded adverse outcomes. These findings should be interpreted cautiously due to the non-randomized design and limited sample size, and further, larger studies with standardized safety and outcome assessment are needed.