Abstracts of the 24th Annual Congress of the European Society for Gynaecological Endoscopy (ESGE), 7th -10th October 2015, Syma – Budapest – Hungary

Abstract

Background To compare the standard hysteroscopic resection and the morcellation approach for endometrial polyps treatment. Methods Prospective non randomized single center study. All the patients treated for a single endometrial polyp between September 2014 and April 2015 at the CMCO hospital in Schiltigheim, France, were prospectively included. Patients were treated by either standard hysteroscopic resection or morcellation. Hysteroscopic resections were performed with standard resectoscopes. Hysteroscopic morcellations were performed with a hysteroscopic morcellator, IBS®, Storz. Results A total of 50 patients were included: 22 were treated by morcellation and 28 by standard hysteroscopic resection. A conversion to a classic procedure was necessary in one case (4,5%) when using the IBS®. The mean age of the patients was 52,8 years. The duration of the procedure was significantly lower in the morcellator group: 6,5 versus 9,7 minutes (p = 0,033). The fluid quantity used during the procedure was lower when using the IBS® device (431 versus 1224 mL; p < 0,001) and so was the fluid deficit at the end of surgery (25 versus 212 mL; p = 0,006). Mean marks for the surgeon's vision quality were higher in the morcellator group (4,6 versus 3,9 on a scale of 5; p = 0,001), and so was the surgeon's comfort (9,5 versus 7,4 on a scale of 10; p < 0,001). The operative device was less frequently reinserted when using the IBS® (1,3 versus 5,8 times; p < 0,001). An asymptomatic Operative Hysteroscopy Intravascular Absorption (OHIA) syndrom was noted in one case (3,4%) in the standard resection group. Most of the cases were performed by a resident in the resection group (65,5%), most of the cases were performed by an attending physician in the morcellation group (72,7% ; p = 0,007), which might induce a bias. Conclusions Our results suggest that endometrial polyps hysteroscopic resection is faster, with less fluid deficit, better vision and better comfort for the surgeon, when a morcellator is used. These results need to be confirmed by a randomized controlled trial.