TY - JOUR
T1 - Long-Term Outcomes After Intrauterine Morcellation vs Hysteroscopic Resection of Endometrial Polyps
AU - AlHilli, Mariam M.
AU - Nixon, Kayla E.
AU - Hopkins, Matthew R.
AU - Weaver, Amy L.
AU - Laughlin-Tommaso, Shannon K.
AU - Famuyide, Abimbola O.
PY - 2013/3
Y1 - 2013/3
N2 - Study 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. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Minimally invasive gynecologic surgery practice in a tertiary care center. Patients: Women who underwent operative hysteroscopic polypectomy between January 1, 2004 and December 31, 2009. Interventions: Intrauterine morcellation or HSR with evaluation and/or treatment of recurrent AUB after operative polypectomy. Measurements and Main 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. Conclusion: 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.
AB - Study 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. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Minimally invasive gynecologic surgery practice in a tertiary care center. Patients: Women who underwent operative hysteroscopic polypectomy between January 1, 2004 and December 31, 2009. Interventions: Intrauterine morcellation or HSR with evaluation and/or treatment of recurrent AUB after operative polypectomy. Measurements and Main 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. Conclusion: 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.
KW - Endometrial polyps
KW - Hysteroscopic resection
KW - Intrauterine morcellation
UR - http://www.scopus.com/inward/record.url?scp=84875372408&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875372408&partnerID=8YFLogxK
U2 - 10.1016/j.jmig.2012.10.013
DO - 10.1016/j.jmig.2012.10.013
M3 - Article
C2 - 23295201
AN - SCOPUS:84875372408
SN - 1553-4650
VL - 20
SP - 215
EP - 221
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
IS - 2
ER -