Related Experiment Video
Updated: May 15, 2026
Improved Hysteroscopic Resection of Endometrial Polyps Using 6-Fr Micro-Scissors and Forceps
Published on: August 2, 2024
Long-term outcomes after intrauterine morcellation vs hysteroscopic resection of endometrial polyps
Mariam M AlHilli1, Kayla E Nixon, Matthew R Hopkins
1Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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.
