Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment

• Main Authors: Angela Mendes Bergamo, Daniella de Batista Depes, Ana Maria Gomes Pereira, Taciana Cristina Duarte de Santana, Umberto Gazi Lippi, Reginaldo Guedes Coelho Lopes
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein 2012-09-01
• Series: Einstein (São Paulo)
• Subjects: Polyps; Hysteroscopy; Pain measurement; Outpatients’ surgical procedures; Endometrium; Anesthesia
• Online Access: http://apps.einstein.br/revista/arquivos/PDF/2198-323-328_eng.pdf

Objective: To compare results of hysteroscopic polypectomy of theendometrium performed in an outpatient clinic, under no anesthesia,to conventional hysteroscopic polypectomy under anesthesia inthe operating theatre, assessing success rate, procedure timeand complications; and to measure pain referred by patients inboth groups. Methods: An observational cross-sectional study of60 patients with hysteroscopic diagnosis of endometrial polyps,divided into two groups: the Outpatient Group, comprising patientssubmitted to outpatient´s hysteroscopic polypectomy by continuousflow vaginoscopy using endoscopic forceps under no anesthesia, andthe Conventional Group with patients submitted to hysteroscopicpolypectomy in the operating theater, using a monopolar resectoscopeunder anesthesia. Results: The groups were similar as to age, parity,mode of delivery and menopausal status. Both groups presented100% efficacy in exeresis of polyps. The mean time of procedurewas 7 minutes in the Outpatient Group and 35.16 minutes in theConventional Group. In the Outpatient Group, menopausal patients(p=0.04) and those with polyps >1cm (p=0.01) had longerprocedures. Using the Verbal Analog Scale of Pain, the mean scoreof pain referred by patients during the procedure was 2.93 in theOutpatient 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. Conclusion: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a welltolerated procedure. As compared to conventional treatment, itdisplays the same efficacy, but the procedure time is shorter and thecomplication rate is lower.