A prospective observational study of the efficacy of endometrial polypectomy by an outpatient transabdominal ultrasound-guided technique in comparison to hysteroscopic removal.

PURPOSE: To compare a novel office procedure for removal of endometrial polyps with inpatient hysteroscopic polypectomy.

METHODS

This was a prospective observational study carried out at a tertiary care center in India. Women undergoing endometrial polypectomy for various indications such as abnormal uterine bleeding; infertility; asymptomatic polyps in postmenopausal women with risk factors for endometrial hyperplasia or cancer were recruited. In group 1, polypectomy was done under transabdominal ultrasound guidance in the outpatient clinic. The women in group 2 had an inpatient hysteroscopic polypectomy under anesthesia. The choice of treatment was decided by the primary physician caring for the patient and the investigator did not have any role in patient selection.

RESULTS

Complete retrieval of the polyp from the endometrial cavity was the primary outcome. This was accomplished in 34/36 (94.4%) and 36/36 (100%) of women in groups 1 and 2 respectively. The median procedure duration was 15 (IQR 12.5-22.5) and 30.5 (IQR 21-36.5) minutes in groups 1 and 2 respectively; p value < 0.001. The median visual analogue pain score was 3 (IQR 2-3) and 2 (IQR 1-2) in groups 1 and 2 respectively; p value < 0.001. In group 2, this was assessed at 6 h post procedure.

CONCLUSION

Ultrasound-guided endometrial polypectomy may be a safe and cost-effective alternative to hysteroscopic polypectomy and is not inferior to the latter in terms of technical success.