Bipolar electrical energy in physiologic solution--a revolution in operative hysteroscopy

Abstract

Study objective: To evaluate the feasibility and efficiency of operative hysteroscopy in physiologic saline solution.

Design: Prospective observational study (Canadian Task Force classification II-2).

Setting: Tertiary university hospital.

Patients: One hundred sixteen women (56% menopausal) with intrauterine pathology with or without symptoms, in whom malignancy was excluded by endometrial sampling.

Intervention: Operative hysteroscopy for resection of uterine septa, lysis of adhesions, and resection of myomas or polyps using a bipolar electrical energy system (VersaPoint) developed for this purpose.

Measurements and main results: Polyps were significantly more common in menopausal than in premenopausal women. Symptoms (mainly bleeding) occurred in 66.9% of premenopausal and 74.5% of menopausal patients. Endometrial polyps and submucous myomata were associated with symptoms in 68% and 70%, respectively. Operating time was less than 25 minutes. Two specimens revealed malignancy. One uncomplicated uterine perforation occurred.

Conclusion: This new technique has the potential to replace monopolar-based intrauterine interventions and may become the treatment of choice for benign intrauterine pathology.