title: Long-term outcomes after intrauterine morcellation vs hysteroscopic resection of endometrial polyps.
abstract: OBJECTIVE
  To compare the long-term outcomes of intrauterine morcellation (IUM) of endometrial polyps vs a traditional operative polypectomy technique, hysteroscopic resection (HSR), and to identify factors predictive of recurrent abnormal uterine bleeding (AUB) after operative polypectomy.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Minimally invasive gynecologic surgery practice in a tertiary care center.
  
  
  METHODS
  Women who underwent operative hysteroscopic polypectomy between January 1, 2004 and December 31, 2009.
  
  
  METHODS
  Intrauterine morcellation or HSR with evaluation and/or treatment of recurrent AUB after operative polypectomy.
  
  
  RESULTS
  Of 311 patients (IUM group, 139; HSR group, 172), 167 (53.7%) had at least 1 gynecologic follow-up visit and 57 (18.4%) had recurrent AUB. Subsequent gynecologic clinic visit rates were similar between the 2 groups (HSR, 58.1%, vs IUM, 48.2%; p = .08). Recurrence of AUB within the first 4 years of follow-up was similar between the IUM and HSR groups (hazard ratio for HSR vs IUM, 1.12; 95% confidence interval, 0.64-1.98; p = .59). However, recurrence of endometrial polyps approached statistical significance (hazard ratio, 3.3; 95% confidence interval, 0.94-11.49; p = .06). Premenopausal status, history of hormone replacement therapy, multiparity, and polycystic ovarian syndrome were independently associated with AUB recurrence. There were no reports of inability to establish a histopathologic diagnosis among all pathology specimens evaluated.
  
  
  CONCLUSIONS
  Compared with HSR, intrauterine morcellation may be associated with lower recurrence of endometrial polyps. However, the incidence of recurrent AUB is independent of polypectomy method.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Mariam M
authors.initials: MM
authors.lastname: AlHilli
authors.forename: Kayla E
authors.initials: KE
authors.lastname: Nixon
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Hopkins
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Shannon K
authors.initials: SK
authors.lastname: Laughlin-Tommaso
authors.forename: Abimbola O
authors.initials: AO
authors.lastname: Famuyide
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D015907:Hysteroscopy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010298:Parity; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011127:Polyps / Q000150:complications / Q000473:pathology / Q000601:surgery*; D017697:Premenopause; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery; D014592:Uterine Hemorrhage / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult