Hysteroscopic polypectomy: a comparison between 22 Fr and 26 Fr resectoscopes under paracervical block anesthesia, a...

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Surgical Instrumentation

Background:

• Endometrial polyps are common gynecologic conditions often treated with hysteroscopic resection.
• Traditional resectoscopes can require significant cervical dilatation, potentially increasing patient discomfort and operative time.
• Paracervical block anesthesia offers an alternative to general anesthesia for hysteroscopic procedures.

Purpose of the Study:

• To compare the efficacy and safety of a 22-Fr unipolar resectoscope versus a 26-Fr unipolar resectoscope for endometrial polypectomy.
• To evaluate operative times, patient-reported pain, and analgesic requirements under paracervical block anesthesia.

Main Methods:

• A randomized trial involving 70 patients with endometrial polyps (<3 cm) was conducted.
• Patients were assigned to either the 22-Fr (Group A) or 26-Fr (Group B) unipolar resectoscope group.
• Primary endpoints included cervical dilatation and resection time; secondary endpoints assessed pain, anesthesia efficacy, and patient satisfaction.

Main Results:

• Mean cervical dilatation time was significantly shorter with the 22-Fr resectoscope (2 min vs. 5 min, p=0.001).
• Mean operative time was also reduced with the 22-Fr resectoscope (4 min vs. 7 min, p=0.001).
• Postoperative pain and need for analgesics were significantly lower in the 22-Fr group.

Conclusions:

• The 22-Fr unipolar resectoscope is advantageous for endometrial polypectomy (<3 cm) due to shorter operative times and reduced patient discomfort.
• Paracervical block anesthesia is a safe and effective option for selected patients undergoing hysteroscopic procedures.
• The smaller resectoscope size facilitates easier procedure and better patient outcomes.