title: A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding.
abstract: Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.
authors.affiliation: Women's Health Research Unit, Queen Mary University of London, London, E1 2AT UK.
authors.forename: Natalie A M
authors.initials: NA
authors.lastname: Cooper
authors.affiliation: Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK.
authors.forename: Lee
authors.initials: L
authors.lastname: Middleton
authors.affiliation: Birmingham Women's NHS Foundation Trust, Birmingham, B15 2TG UK ; School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, B15 2TT UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Smith
authors.affiliation: Centre for Health and Social Care Research, Birmingham City University, Birmingham, B15 3TN UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Denny
authors.affiliation: School of Allied and Public Health Professions, Birmingham City University, Birmingham, B15 3TN UK.
authors.forename: Lynda
authors.initials: L
authors.lastname: Stobert
authors.affiliation: Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Daniels
authors.affiliation: Birmingham Women's NHS Foundation Trust, Birmingham, B15 2TG UK ; OPT Trial Office, Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, Robert Aitken Institute for Clinical Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK.
authors.forename: T Justin
authors.initials: TJ
authors.lastname: Clark
keywords: Abnormal uterine bleeding; Ambulatory gynaecology; Office polypectomy; Patient preference; Uterine polyp