Comparison of resectoscope and tissue removal device in managing chronic endometritis associated with endometrial...

Hysteroscopic polypectomy has therapeutic effects on chronic endometritis (CE) associated with endometrial polyps (EPs), even without antibiotic use. We aim to compare the cure rates of CE after hysteroscopic polypectomy using a conventional resectoscope versus a tissue removal device. A retrospective cohort study was conducted on 239 consecutive infertile patients with EPs. Among them, 129 women underwent hysteroscopic removal of both EPs and endometrium with typical CE findings, such as an erythematous surface, stromal edema, or micropolyps, using a resectoscope (RS group) from January 2021 to June 2022, whereas 110 women underwent resection of EPs alone using a tissue removal device (TRD group) from July 2022 to April 2025. Thereafter, surgical specimens underwent immunostaining for CD138 to diagnose CE. Women diagnosed with CE underwent endometrial biopsy without antibiotic use during the subsequent menstrual cycle. The median (IQR) number of CD138-positive cells per 10 high-power fields was 12 (5-29) in the RS group and 15 (7.5-25) in the TRD group (p = 0.35), with the prevalence of CE being 80.6% (104/129 women) and 84.5% (93/110 women), respectively (p = 0.50). After surgery, 87.9% (80/91 women) and 84.0% (68/81 women) of the women in the RS and TRD groups were cured of CE, respectively (p = 0.51). No significant differences in the pregnancy outcomes of fertility treatment within 6 months were noted between the two groups. Cure rates for CE associated with EPs were comparable regardless of whether a conventional resectoscope or a tissue removal device was used.