Massive hemorrhage after resection of uterine endocervical polyp and endometrial polyps with hysteroscopic tissue removal system

Abstract

Abstract Rationale: Hysteroscopic tissue removal system has clinical benefits of short operation time, high total resection rate, and high patient acceptability. It has been reported to be as safe as electrosurgical resection with fewer complications. We report a case of massive hemorrhage after resection of endocervical polyp and endometrial polyps with TruClear, hysteroscopic morcellator. Patient concerns: A 47-year-old woman visited our hospital with vaginal discomfort. Diagnosis: Based on the hysteroscopic findings and imaging findings, endocervical polyp and multiple endometrial polyps were diagnosed. Interventions: Hysteroscopic resection with TruClear was performed. Thirteen hours after the surgery, massive hemorrhage from uterus was observed. Imaging examination revealed bleeding from left uterine artery and uterine artery embolization was performed. Outcomes: After uterine artery embolization, bleeding stopped, and further hospitalization course was uneventful. Pathological diagnosis was endocervical polyp and endometrial polyps with no malignant findings. Lessons: Hysteroscopic tissue removal has several clinical benefits. However, our case report shows that there is a possibility of significant hemorrhage associated with hysteroscopic tissue removal system.