Abstract
To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain referred by patients in both groups. An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient's hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps >1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.
Highlights
The endometrial polyp is a focal hyperplasia of the basal layer of the endometrium, which originates a localized tumor and is covered by glandular epithelium
A total of 30 patients submitted to hysteroscopic polypectomy of the endometrium performed at the hysteroscopy outpatient clinic comprised the Outpatient Group (OG), and 30 patients submitted to conventional hysteroscopic polypectomy, performed in the operating room, formed the Conventional Group (CG)
Single polyps were diagnosed in 63.3% of the patients, and the mean number of polyps per patient was 1.43 in the OG group and 1.46 in the CG group
Summary
The endometrial polyp is a focal hyperplasia of the basal layer of the endometrium, which originates a localized tumor and is covered by glandular epithelium. In histology, it is recognized by glands of varied aspect, fibrous stroma and vessels with thickened walls[1]. Polyps may be single or multiple, of various sizes, sessile or pediculate, and their vascularized base may externalize through the uterine cervix[1]. They account for approximately one fourth of the cases of abnormal uterine bleeding (AUB) in women before and after menopause
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