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Bipolar electrical energy in physiologic solution--a revolution in operative hysteroscopy
1Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon 58100, Israel.
Study Objective:
To evaluate the feasibility and efficiency of operative hysteroscopy in physiologic saline solution.
Design:
Prospective observational study (Canadian Task Force classification II-2).
Setting:
Tertiary university hospital.
Patients:
One hundred sixteen women (56% menopausal) with intrauterine pathology with or without symptoms, in whom malignancy was excluded by endometrial sampling.
Intervention:
Operative hysteroscopy for resection of uterine septa, lysis of adhesions, and resection of myomas or polyps using a bipolar electrical energy system (VersaPoint) developed for this purpose.
Measurements And Main Results:
Polyps were significantly more common in menopausal than in premenopausal women. Symptoms (mainly bleeding) occurred in 66.9% of premenopausal and 74.5% of menopausal patients. Endometrial polyps and submucous myomata were associated with symptoms in 68% and 70%, respectively. Operating time was less than 25 minutes. Two specimens revealed malignancy. One uncomplicated uterine perforation occurred.
Conclusion:
This new technique has the potential to replace monopolar-based intrauterine interventions and may become the treatment of choice for benign intrauterine pathology.