Resectoscope versus small diameter hysteroscopy for endometrial polypectomy in patients with "unfavorable" cervix.
BACKGROUND
The aim of this study was to compare resectoscopic and small-diameter hysteroscopic techniques for endometrial polypectomy in patients with "unfavorable" cervix.


METHODS
Eighty women with a single 2-4 cm sized endometrial polyp, with unfavorable cervical anatomical conditions were enrolled in the study. Forty patients were treated with a 26F resectoscope requiring cervical dilatation (group A), forty patients were treated with a 5-mm hysteroscope requiring vaginoscopic approach (group B). Operative time, fluid absorption, complications, instrument failure, postoperative pain, overnight stay were analyzed. Operative visualization, operative difficulty and overall surgeon's satisfaction were assessed with a Visual Analogue Scale (VAS).


RESULTS
Operative time was significantly longer in group A than in group B (18.3±7.4 vs. 11.3±5.2 minutes), the cumulative complication rate and the need of postoperative analgesics were higher in group A than in group B. VAS of surgical difficulty and surgeon's satisfaction were higher in group B than in group A.


CONCLUSIONS
The small-diameter hysteroscopy is a safe and effective approach for endometrial polyp up to 4 cm in patients with unfavorable cervical canal at risk of cervical injury.
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy - pasquale.defranciscis@unina2.it.
Pasquale
P
DE Franciscis
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy.
Flavio
F
Grauso
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy.
Enrico M
EM
Messalli
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy.
Maria T
MT
Schettino
Department of Obstetrics and Gynecology, University of Palermo, Palermo, Italy.
Gloria
G
Calagna
Department of Obstetrics and Gynecology, University of Palermo, Palermo, Italy.
Antonino
A
Perino
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy.
Nicola
N
Colacurci
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, Naples, Italy.
Marco
M
Torella
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D002584:Cervix Uteri / Q000473:pathology; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D011127:Polyps / Q000473:pathology / Q000601:surgery*
D000700:Analgesics