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

Abstract:

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.

journal_name

Obstet Gynecol

authors

Smith PP,Middleton LJ,Connor M,Clark TJ

doi

10.1097/AOG.0000000000000187

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

745-51

issue

4

eissn

0029-7844

issn

1873-233X

pii

00006250-201404000-00004

journal_volume

123

pub_type

杂志文章,多中心研究,随机对照试验
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    authors: Garite TJ,Linzey EM,Freeman RK,Dorchester W

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  • Diagnosis and resection of an oral contraceptive-suppressible Sertoli-Leydig cell tumor with preservation of fertility and a 7-year follow-up.

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    doi:

    authors: Haning RV Jr,Loughlin J,Shapiro SS

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  • The effect of cocaine abuse on birth weight and gestational age.

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    authors: Chouteau M,Namerow PB,Leppert P

    更新日期:1988-09-01 00:00:00

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    doi:

    authors: Soper JT,Evans AC,Clarke-Pearson DL,Berchuck A,Rodriguez G,Hammond CB

    更新日期:1994-01-01 00:00:00

  • Leukocytes in the cervix: a quantitative evaluation of cervicitis.

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    更新日期:1998-06-01 00:00:00

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    authors: Iriye BK,Bristow RE,Hsu CD,Bruni R,Johnson TR

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    journal_title:Obstetrics and gynecology

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    doi:

    authors: Mariona FG,Ismail MA

    更新日期:1980-10-01 00:00:00

  • Development of a multiple marker test for ectopic pregnancy.

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    pub_type: 临床试验,杂志文章

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    authors: Rausch ME,Sammel MD,Takacs P,Chung K,Shaunik A,Barnhart KT

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    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

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    doi:

    authors: Kresch AJ,Seifer DB,Sachs LB,Barrese I

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    doi:

    authors: Ingemarsson I,Bengtsson B

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Shoupe D,Mishell DR Jr,Lacarra M,Lobo RA,Horenstein J,d'Ablaing G,Moyer D

    更新日期:1989-01-01 00:00:00

  • Maternal and neonatal outcomes of successful Kielland's rotational forceps delivery.

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    authors: Stock SJ,Josephs K,Farquharson S,Love C,Cooper SE,Kissack C,Akolekar R,Norman JE,Denison FC

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  • First-trimester drug use and congenital disorders.

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    journal_title:Obstetrics and gynecology

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    doi:

    authors: Aselton P,Jick H,Milunsky A,Hunter JR,Stergachis A

    更新日期:1985-04-01 00:00:00

  • Modified Beef Tongue Model for Fourth-Degree Laceration Repair Simulation.

    abstract:BACKGROUND:An existing model for fourth-degree laceration repair uses beef tongue with plastic or vinyl tubing. This modified model substitutes beef tripe for the anal mucosa and chicken leg muscles for the anal sphincter muscle analogs to create a realistic model. METHOD:Tripe is tunneled through the body of the trim...

    journal_title:Obstetrics and gynecology

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    authors: Illston JD,Ballard AC,Ellington DR,Richter HE

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  • ACOG Committee Opinion No. 766 Summary: Approaches to Limit Intervention During Labor and Birth.

    abstract::Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that require minimal interventions and have high rates of patient satisfaction. Many common obstetric practices are of limited or un...

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    pub_type: 社论

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  • An Initiative to Reduce the Episiotomy Rate: Association of Feedback and the Hawthorne Effect With Leapfrog Goals.

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    journal_title:Obstetrics and gynecology

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

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    journal_title:Obstetrics and gynecology

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:

    authors: Cook CL,Sanfilippo JS,Verdi GD,Pietsch JB

    更新日期:1989-05-01 00:00:00

  • Typhoid fever in pregnancy.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Seoud M,Saade G,Uwaydah M,Azoury R

    更新日期:1988-05-01 00:00:00

  • Antepartum detection of macrosomic fetus: clinical versus sonographic, including soft-tissue measurements.

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    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00606-7

    authors: Chauhan SP,West DJ,Scardo JA,Boyd JM,Joiner J,Hendrix NW

    更新日期:2000-05-01 00:00:00

  • Use of recombinant activated factor VII in primary postpartum hemorrhage: the Northern European registry 2000-2004.

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    pub_type: 杂志文章

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    doi:

    authors: Lewis V,Khan-Dawood F,King M,Beckmann C,Dawood MY

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