Ultrasound-Guided Endometrial Polypectomy Performed in an Office Setting Without Hysteroscopy

Endometrial polyps are localized overgrowths of the endometrium that protrude into the endometrial cavity. Symptomatic persistent endometrial polyps warrant removal. Hysteroscopic polypectomy is the gold standard for endometrial polyp removal, with office-based procedures gaining popularity in recent years. We report an alternative technique of endometrial polypectomy in the office under transabdominal ultrasound guidance using an atraumatic 5-mm laparoscopic grasper, which is particularly useful when a hysteroscope is unavailable. This procedure could be successfully completed in more than 95% of women within a median duration of 15 minutes, with a median pain score of 3 on a scale of 10. The advantages of a laparoscopic grasper over the oft-used ovum forceps or sponge-holding forceps are also highlighted. Ultrasound-guided outpatient polypectomy appears to be a safe, well-tolerated, and cost-effective alternative to hysteroscopy for endometrial polypectomy and warrants further research.