Resectoscopic versus bipolar electrode excision of endometrial polyps: a randomized study

Abstract

Objective: To evaluate operative resectoscopy versus hysteroscopic bipolar electrode excision for the treatment of endometrial polyps.

Design: Prospective, randomized study.

Setting: Tertiary-care university hospital.

Patient(s): One hundred consecutive patients with endometrial polyps.

Intervention(s): Patients underwent diagnostic hysteroscopy, and after assignment on a random basis, they underwent polyp excision either by operative resectoscopy or by a bipolar electrode passed through the operating sheath of a small-caliber hysteroscope. MAIN OUTCOME MEASURE(S) AND RESULT(S): Operating times, difficulty of the operation, surgeon satisfaction with the procedure, intra- and postoperative complications, postoperative pain, and patient satisfaction were recorded. The two procedures did not differ in total surgery times. In subgroup analysis, the resectoscope was faster for large polyps (>2 cm) and for polyps with a fundal implant. The bipolar electric probe was faster for small polyps (<2 cm) and for polyps with a nonfundal implant.

Conclusion(s): Operative resectoscopy appears to be the technique of choice for endometrial polyps >2 cm or with a fundal implant. Bipolar electrode excision appears to be preferable for smaller, nonfundal polyps.