Effectiveness of Hysteroscopic Morcellation of Endometrial Polyps Compared to Traditional Technique: A Comparison of Disease Recurrence

STUDY OBJECTIVE: To compare the outcomes between hysteroscopic morcellation of endometrial polyps and traditional techniques such as hysteroscopic resection with monopolar or bipolar radiofrequency energy, scissors and graspers or mechanical resection with polyp forceps. DESIGN: Retrospective chart review. SETTING: Academic tertiary referral center. PATIENTS OR PARTICIPANTS: 193 patients who underwent operative hysteroscopic polypectomy between January 2015 and May 2016. INTERVENTIONS: Hysteroscopic polypectomy with intrauterine morcellation, monopolar or bipolar radiofrequency energy, scissors and graspers or mechanical resection with polyp forceps with evaluation and/or treatment of recurrent abnormal uterine bleeding (AUB) after operative polypectomy. MEASUREMENTS AND MAIN RESULTS: There were 9 patients who underwent hysteroscopic polypectomy with monopolar radiofrequency energy, 3 patients with bipolar radiofrequency energy, 91 patients with intrauterine morcellation, 67 patients with polyp forceps and 12 patients with scissors and graspers. The recurrence rate for AUB for monopolar was 1.89%, bipolar was 1.67%, intrauterine morcellation was 1.93%, polyp forceps was 1.84% and hysteroscopic scissors and/or graspers was 1.83%. Among the recurrences the average time until recurrence was 1162 days for monopolar, 207 days for bipolar, 749.5 days for intrauterine morcellation, 477.6 days for polyp forceps and 341.5 days for hysteroscopic scissors and graspers. CONCLUSION: There was no significant difference in terms of recurrence of AUB following the different modalities of operative hysteroscopy. Among the patients with recurrence in order of shortest time until recurrence: bipolar, hysteroscopic scissors and graspers, polyp forceps, intrauterine morcellation and monopolar.