65447
document
Hysteroscopic morcellation compared with electrical resection of endometrial polyps : a randomized controlled trial . OBJECTIVE To evaluate whether hysteroscopic morcellation or bipolar electrosurgical resection is more favorable for removing endometrial polyps in an office setting in terms of feasibility , speed , pain , and acceptability . METHODS A multicenter , single-blind , randomized , controlled trial of office hysteroscopic morcellation compared with electrosurgical resection was conducted . A total of 121 women were randomly allocated to polyp removal by one of the two methods in an office setting . The outcomes assessed were time taken to complete the endometrial polypectomy , defined as the time from insertion to removal of vaginal instrumentation , completeness of polyp removal , acceptability , and pain measured on a 100-mm visual analog scale . RESULTS The median time taken to complete the procedure was 5 minutes and 28 seconds for morcellation compared with 10 minutes and 12 seconds for electrosurgical resection ( P < .001 ) . The polyps were completely removed in 61 out of 62 ( 98 % ) women assigned to morcellation compared with 49 out of 59 ( 83 % ) women treated with electrosurgical resection ( odds ratio 12.5 ; 95 % confidence interval [ CI ] 1.5-100.6 ; P=.02 ) . The mean pain scores during the procedure favored morcellation by 16.1 points on average ( 35.9 compared with 52.0 ; 95 % CI for difference , -24.7 to -7.6 ; P < .001 ) . Overall , 99 % of women found office polypectomy to be acceptable , with only one woman in the electrosurgical resection group considering the procedure unacceptable . CONCLUSION In comparison to electrosurgical resection during hysteroscopic polypectomy , morcellation was significantly quicker , less painful , more acceptable to women , and more likely to completely remove endometrial polyps compared with electrosurgical resection . CLINICAL TRIAL REGISTRATION ClinicalTrials.gov , www.clinicaltrials.gov , NCT01509313 .
65448
Intervention_Surgical
Hysteroscopic morcellation
65449
Intervention_Pharmacological
electrical resection
65450
Intervention_Surgical
hysteroscopic morcellation
65451
Intervention_Surgical
bipolar electrosurgical resection
65452
Intervention_Surgical
office hysteroscopic morcellation
65453
Intervention_Pharmacological
electrosurgical resection
65454
Intervention_Surgical
morcellation
65455
Intervention_Pharmacological
electrosurgical resection
65456
Intervention_Surgical
morcellation
65457
Intervention_Pharmacological
electrosurgical resection
65458
Intervention_Pharmacological
electrosurgical resection
65459
Intervention_Surgical
morcellation
65460
Intervention_Pharmacological
electrosurgical resection
65461
Outcome_Physical
endometrial polyps
65462
Outcome_Other
feasibility
65463
Outcome_Other
speed
65464
Outcome_Pain
pain
65465
Outcome_Other
acceptability
65466
Outcome_Other
time taken to complete the endometrial polypectomy
65467
Outcome_Other
completeness of polyp removal , acceptability
65468
Outcome_Pain
pain
65469
Outcome_Other
median time taken to complete the procedure
65470
Outcome_Other
polyps were completely removed
65471
Outcome_Pain
mean pain scores
65472
Outcome_Other
acceptable
65473
Outcome_Other
unacceptable
65474
Outcome_Other
quicker
65475
Outcome_Pain
painful
65476
Outcome_Other
acceptable
65477
Outcome_Physical
completely remove endometrial polyps
65478
Participant_Condition
endometrial polyps