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Rivista di Ostetricia e Ginecologia

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Minerva Ginecologica 2016 Nov 11

lingua: Inglese

Resectoscope versus small diameter hysteroscopy for endometrial polypectomy in patients with “unfavorable” cervix

Pasquale DE FRANCISCIS 1, Flavio GRAUSO 1, Enrico M. MESSALLI 1, Maria T. SCHETTINO 1, Gloria CALAGNA 2, Antonino PERINO 2, Nicola COLACURCI 1, Marco TORELLA 1

1 Department of Woman, Child of General and Specialist Surgery, Second University of Naples, Napoli, Italy; 2 Department of Obstetrics and Gynecolgy, University of Palermo, Palermo, Italy


BACKGROUND: To compare resectoscopic and small-diameter hysteroscopic techniques for endometrial polypectomy in patients with “unfavorable” cervix.
METHODS: Eighty women with a single 2-4 cm sized endometrial polyp, with unfavorable cervical anatomical conditions were enrolled in the study. Forty patients were treated with a 26F resectoscope requiring cervical dilatation (group A), forty patients were treated with a 5-mm hysteroscope requiring vaginoscopic approach (group B). Operative time, fluid absorption, complications, instrument failure, postoperative pain, overnight stay were analyzed. Operative visualization, operative difficulty and overall surgeon’s satisfaction were assessed with a visual analogue scale.
RESULTS: Operative time was significantly longer in group A than in group B (18.3±7.4 vs 11.3±5.2 minutes), the cumulative complication rate and the need of post-operative analgesics were higher in group A than in group B. Visual analogue scale of surgical difficulty and surgeon’s satisfaction were higher in group B than in group A.
CONCLUSIONS: The small-diameter hysteroscopy is a safe and effective approach for endometrial polyp up to 4 cm in patients with unfavorable cervical canal at risk of cervical injury.

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