STUDY OBJECTIVE: To evaluate the feasibility and efficiency of operative hysteroscopy in physiologic saline solution. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Tertiary university hospital. PATIENTS: One hundred sixteen women (56% menopausal) with intrauterine pathology with or without symptoms, in whom malignancy was excluded by endometrial sampling. INTERVENTION: Operative hysteroscopy for resection of uterine septa, lysis of adhesions, and resection of myomas or polyps using a bipolar electrical energy system (VersaPoint) developed for this purpose. MEASUREMENTS AND MAIN RESULTS: Polyps were significantly more common in menopausal than in premenopausal women. Symptoms (mainly bleeding) occurred in 66.9% of premenopausal and 74.5% of menopausal patients. Endometrial polyps and submucous myomata were associated with symptoms in 68% and 70%, respectively. Operating time was less than 25 minutes. Two specimens revealed malignancy. One uncomplicated uterine perforation occurred. CONCLUSION: This new technique has the potential to replace monopolar-based intrauterine interventions and may become the treatment of choice for benign intrauterine pathology.
STUDY OBJECTIVE: To evaluate the feasibility and efficiency of operative hysteroscopy in physiologic saline solution. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Tertiary university hospital. PATIENTS: One hundred sixteen women (56% menopausal) with intrauterine pathology with or without symptoms, in whom malignancy was excluded by endometrial sampling. INTERVENTION: Operative hysteroscopy for resection of uterine septa, lysis of adhesions, and resection of myomas or polyps using a bipolar electrical energy system (VersaPoint) developed for this purpose. MEASUREMENTS AND MAIN RESULTS:Polyps were significantly more common in menopausal than in premenopausal women. Symptoms (mainly bleeding) occurred in 66.9% of premenopausal and 74.5% of menopausal patients. Endometrial polyps and submucous myomata were associated with symptoms in 68% and 70%, respectively. Operating time was less than 25 minutes. Two specimens revealed malignancy. One uncomplicated uterine perforation occurred. CONCLUSION: This new technique has the potential to replace monopolar-based intrauterine interventions and may become the treatment of choice for benign intrauterine pathology.
Authors: Lotte L Nieuwenhuis; Frederik Jr Hermans; A J Marjolein Bij de Vaate; Mariska Mg Leeflang; Hans Am Brölmann; Wouter Jk Hehenkamp; Ben Willem J Mol; T Justin Clark; Judith Af Huirne Journal: Cochrane Database Syst Rev Date: 2017-05-05