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Saturday, March 22, 2014
Trailers (77): Office hysteroscopic removal of endometrial polyps

Smith et al. Hysteroscopic morcellation compared with electrical resection of endometrial polyps: a randomized controlled trial

Why should you read about this topic?

Because anytime you can move a procedure from the OR to the office everyone benefits.

What were the authors trying to do?

To compare office hysteroscopic morcellation with electrosurgical resection of endometrial polyps in duration of surgery, pain, and acceptability

Who participated and in what setting?

Women (N=121) with endometrial polyps planning hysteroscopic surgery at two teaching hospitals in the UK between 2012 and 2013

What was the study design?

Multicenter, single-masked randomized controlled trial of hysteroscopic morcellation or electrosurgical resection

What were the main outcome measures?

Time to completion

What were the results?

Median time to completion was about 5½ minutes for morcellation compared with almost twice that duration for electrosurgical resection.  Complete removal was more likely with morcellation and pain scores were lower in comparison with electrosurgical resection.

What is the most interesting image in the paper?

Video

What were the study strengths and weaknesses?

Strengths: randomized controlled trial; thoughtful stratification for polyp location. Weaknesses: no estimate of percent eligibility within the pool of women needing surgical treatment of endometrial polyps; no comparative cost analysis

What does the study contribute for your practice?

Office hysteroscopic morcellation is quicker and less painful than electrical resection of endometrial polyps

About the Author

William C. Dodson, MD
William C. Dodson, MD, is Professor of Obstetrics and Gynecology and Director of the Division of Reproductive Endocrinology and Infertility at Penn State College of Medicine. He completed his fellowship in reproductive endocrinology at Duke University. His research and clinical areas of focus include treatment of infertility, especially ovulation induction. He was previously on the Editorial Board of Obstetrics & Gynecology and has served as the Consultant Web Editor for Obstetrics & Gynecology since 2008.

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