title: Removal of Endometrial Polyps: Hysteroscopic Morcellation versus Bipolar Resectoscopy, A Randomized Trial.
abstract: OBJECTIVE
  To compare hysteroscopic morcellation with bipolar resectoscopy for removal of endometrial polyps, in terms of procedure time, peri- and postoperative adverse events, tissue availability, and short-term effectiveness.
  
  
  METHODS
  Multicenter, open label, randomized controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  Day surgery setting of a teaching and a university hospital.
  
  
  METHODS
  Women with larger (≥1 cm) endometrial polyps.
  
  
  METHODS
  Hysteroscopic morcellation with the TRUCLEAR 8.0 Tissue Removal System or bipolar resectoscopy with a rigid 8.5-mm bipolar resectoscope.
  
  
  RESULTS
  Eighty-four women were included in the intention-to-treat analysis. Median operating time was 4.0 min (range: 2.5-7.1) and 6.0 min (range: 3.8-11.7) in the hysteroscopic morcellation and resectoscopy groups, respectively. Operating time was reduced by 38% (95% confidence interval: 5%-60%; p = .028) in the hysteroscopic morcellation group. Procedure time, which was defined as the sum of the installation and operating time, tended to be less for the hysteroscopic morcellation group (median 9.5 min [range: 7.6-12.2] vs 12.2 min [range: 8.8-16.0]; p = .072). Perforation occurred at dilation or hysteroscope (re)introduction in 3 patients of the resectoscopy group, resulting in procedure discontinuation or prolongation of hospital stay. Perforation occurred at dilation in 1 patient in the hysteroscopic morcellation group; however, the procedure was successfully completed. Postoperatively, 2 patients of the hysteroscopic morcellation group were diagnosed with a urinary tract infection. Tissue was available for pathology analysis in all patients, except for 2 patients in the resectoscopy group in whom the procedure was discontinued due to perforation.
  
  
  CONCLUSIONS
  Hysteroscopic morcellation is a fast, effective, and safe alternative to bipolar resectoscopy for removal of endometrial polyps.
authors.affiliation: Women's Clinic, Ghent University Hospital, Ghent, Belgium. Electronic address: Tjalina.Hamerlynck@Ugent.be.
authors.forename: Tjalina W O
authors.initials: TW
authors.lastname: Hamerlynck
authors.affiliation: Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Benedictus C
authors.initials: BC
authors.lastname: Schoot
authors.affiliation: Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Huib A A M
authors.initials: HA
authors.lastname: van Vliet
authors.affiliation: Women's Clinic, Ghent University Hospital, Ghent, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Weyers
mesh_terms: D000328:Adult; D001530:Belgium / Q000453:epidemiology; D004598:Electrosurgery / Q000379:methods; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008875:Middle Aged; D000069577:Morcellation / Q000379:methods; D009426:Netherlands / Q000453:epidemiology; D061646:Operative Time; D011127:Polyps / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Bipolar resectoscopy; Endometrial polyps; Hysteroscopic morcellation; Operative hysteroscopy; Randomized trial