Benign Endometrial Polyp Recurrence after Office Hysteroscopic Polypectomy According to Surgical Procedure

Abstract

Study Objective To compare the recurrence of benign endometrial polyps after hysteroscopic polypectomy performed with bipolar electrode (BE) or a small diameter hysteroscopic tissue removal system (HTRs). Design Prospective randomized study approved by the Institutional Review Board. Setting University-Hospital. Patients or Participants From January to December 2017, 93 of 120 fertile women, with a single endometrial polyp (between 10 and 20 mm) accepted to participate in the study and were randomized into two groups according to the type of surgical procedure assigned them by “QuickCalcs” of “Graphpad Software”. Only women with removed polyps, classified as “benign” after pathological assessment, were considered. Interventions A 4mm hysteroscope (Karl Storz, Germany) with BE (Versapoint, Gynecare) was used for 51 women (BE Group). The 5mm HTRs (TruClear 5C System, Medtronic, Ireland) was used for 42 patients (TruClear Group). All hysteroscopic polypectomies were performed in an office setting with the vaginoscopic approach during the early proliferative phase. Patients were scheduled for a 12-month postoperative transvaginal ultrasound evaluation. Measurements and Main Results Polyps were completely removed in 48 out of 51 (94.12%) BE group and in 40 out of 42 HTR group (95.24%). The median time for polypectomy was significantly lower for HTR group (3.6 ± 1.7 minutes) compare to 8.7 ± 2.8 minutes for the BE Group, p Conclusion In this prospective randomized study, hysteroscopic endometrial polypectomy resulted significantly quicker with small HTRs compared to BE without differences in terms of complete removal and recurrence of polyps.