Long-Term Outcomes After Intrauterine Morcellation vs Hysteroscopic Resection of Endometrial Polyps

Mariam M. AlHilli, Kayla E. Nixon, Matthew R. Hopkins, Amy L. Weaver, Shannon K Laughlin-Tommaso, Abimbola O. Famuyide

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)215-221
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume20
Issue number2
DOIs
StatePublished - Mar 2013

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Polyps
Uterine Hemorrhage
Recurrence
Confidence Intervals
Gynecologic Surgical Procedures
Minimally Invasive Surgical Procedures
Polycystic Ovary Syndrome
Hormone Replacement Therapy
Advisory Committees
Ambulatory Care
Parity
Morcellation
Tertiary Care Centers
Cohort Studies
Retrospective Studies
Pathology
Incidence

Keywords

  • Endometrial polyps
  • Hysteroscopic resection
  • Intrauterine morcellation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Long-Term Outcomes After Intrauterine Morcellation vs Hysteroscopic Resection of Endometrial Polyps. / AlHilli, Mariam M.; Nixon, Kayla E.; Hopkins, Matthew R.; Weaver, Amy L.; Laughlin-Tommaso, Shannon K; Famuyide, Abimbola O.

In: Journal of Minimally Invasive Gynecology, Vol. 20, No. 2, 03.2013, p. 215-221.

Research output: Contribution to journalArticle

AlHilli, Mariam M. ; Nixon, Kayla E. ; Hopkins, Matthew R. ; Weaver, Amy L. ; Laughlin-Tommaso, Shannon K ; Famuyide, Abimbola O. / Long-Term Outcomes After Intrauterine Morcellation vs Hysteroscopic Resection of Endometrial Polyps. In: Journal of Minimally Invasive Gynecology. 2013 ; Vol. 20, No. 2. pp. 215-221.
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AU - Laughlin-Tommaso, Shannon K

AU - Famuyide, Abimbola O.

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