Comparative analysis of intraoperative parameters in hysteroscopic treatment of uterine polyps of different sizes

Abstract

Objective: To analyze the intraoperative parameters in the hysteroscopic treatment of uterine polyps of different sizes.

Materials and methods: A retrospective study included 177 patients with abnormal uterine bleeding and / or ultrasound data for uterine polyps over a period of two years. Hysteroscopic morcellation (HM) was performed to 98 (55%) of them, and hysteroscopic resection (HR) in 79 (45%). According to the size of the polyps, the distribution is as follows: up to 1 cm - 70 (39%) cases [40 (23%) - HM, 30 (17%) - HR]; 1-2 cm - 92 (51%) cases [49 (28%) - HM, 43 (24%) - HR]; over 2 cm - 18 (10%) cases [10 (6%) - HM, 8 (4%) - HR]. The following intraoperative indicators were analyzed: total duration of the procedure, total operative time, dilation time, actual operative time for HM / HR, amount of distension fluid used and distension fluid deficiency. The data were entered and processed with the statistical package IBM SPSS Statistics 25.0 and Med Calc Version 14.8.1. For a significance level at which the null hypothesis is rejected, p <0.05 was assumed.

Results: The operative time, estimated as “total duration of the procedure”, “total operative time”, “actual operative time” and “dilation time” is significantly shorter in HM compared to HR, resp. 8.27 versus 19.48 minutes (p = 0.001); 6.15 versus 16.33 minutes (p = 0.001); 3.28 versus 11.70 min (0.001) and 1.37 versus 1.54 min (p = 0.03). The amount of distension fluid used is statistically significantly less in HM compared to HR, resp. 446.02 ml versus 2225.57 ml (p = 0.001). There are similar results in the indicator "deficiency of distension fluid", respectively. 83.78 ml versus 413.48 ml (p = 0.001).

Conclusion: Hysteroscopic morcellation offers an opportunity for a new look in the surgical treatment of uterine polyps. It allows for shorter operative time and greater safety in its application. At the same time, it proves to be a sufficiently effective alternative to traditional hysteroscopic resection.