title: A Prospective Multicenter Registry of Patients Undergoing Hysteroscopic Morcellation of Uterine Polyps and Myomas.
abstract: Background:Hysteroscopic morcellation removes uterine pathology under direct visualization with continuous real-time tissue fragment removal.Objective:The aim of this study was to explore the feasibility of hysteroscopic morcellation across a diverse set of facilities, including both surgical and office-based settings.Design:This was a prospective, single-arm, multicenter registry development (Canadian Task Force classification II-3).Materials and Methods:Thirty-four U.S. obstetrics and gynecology facilities enrolled subjects into the registry. Inclusion criteria were women ages 18-65 with indications for hysteroscopic myomectomy and/or polypectomy who were treated with the MyoSure® Hysteroscopic Tissue Removal System (Hologic Inc., Marlborough, MA). Intrauterine lesion type/size and removal parameters, adverse events (AEs), and physician satisfaction ratings were recorded.Results:A total of 559 pathologies (187 fibroids; 372 polyps) were removed from 278 registered subjects (mean age: 43.9 ± 9.0 years), with 250 procedures (89.9%) performed in an ambulatory surgery center or hospital outpatient setting and 28 (10.1%) in a gynecologic office setting. Most patients (n= 206, 74.1%) were treated for abnormal uterine bleeding, and 42 (15.1%) were treated for infertility. Mean fibroid diameter was 2.2 ± 1.2 cm. Mean polyp diameter was 1.3 ± 1.0 cm. Overall mean percentage of pathology removed was 95.4% (polyps 99.3%, fibroids 86.8%). Five AEs included four incidents of blunt cervical trauma and a single postoperative case of pedal edema; all were considered mild and resolved spontaneously. Postprocedure surveys indicated that 95% of reporting physicians were "satisfied" or "highly satisfied" with device performance.Conclusions:Hysteroscopic morcellation of intrauterine pathology was accomplished safely with a high degree of physician satisfaction in 278 patients treated in diverse healthcare settings that are reflective of general community practice in the United States. (J GYNECOL SURG 32:318).
authors.affiliation: Institute for Reproductive Health , Cincinnati, OH.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Scheiber
authors.affiliation: Institute for Reproductive Medicine and Science at Saint Barnabas Medical Center , Livingston, NJ.
authors.forename: Serena H
authors.initials: SH
authors.lastname: Chen
keywords: endometrial polyp; hysteroscopic morcellator; intrauterine morcellation; submucous myoma