Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode

TLDR

The new 5 Fr bipolar electrode enables office hysteroscopic treatment of benign intrauterine pathologies without anaesthesia. The study aimed to evaluate the efficacy and patient acceptability of this 5 Fr bipolar probe for office hysteroscopic management of benign intrauterine lesions. The procedure employed a Versapoint 5 Fr bipolar electrical generator to treat endometrial polyps (0.5–4.5 cm) and submucosal or partially intramural myomas (0.6–2.0 cm) in 501 women, performed without analgesia or anaesthesia. All 501 patients had normal uterine cavities at follow‑up with no recurrence, 47.6–79.3 % reported no discomfort, one case of focal adenocarcinoma was identified, and a modified generator set‑up further reduced operative discomfort.

Abstract

The aim of this study was to evaluate treatment efficacy and patient acceptability of a new bipolar probe used during office hysteroscopic treatment of benign intrauterine pathologies.In this observational clinical study, 501 women were treated for benign intrauterine pathologies using an office hysteroscopic procedure, without analgesia or anaesthesia. A Versapoint 5 Fr. bipolar electrical generator was used to treat endometrial polyps ranging between 0.5 and 4.5 cm, as well as submucosal and partially intramural myomas between 0.6 and 2.0 cm. Treatment efficacy and patient compliance were evaluated.At follow-up, the uterine cavity was normal in all patients without any recurrence or persistence of the pathology. One focal adenocarcinoma was discovered at histology in an endometrial polyp of a menopausal patient. Patient acceptance was satisfactory; 47.6-79.3% of the patients underwent the procedure without discomfort.The combination of a new generation small diameter hysteroscope and a new bipolar 5 Fr. electrode enables the gynaecologist to treat intrauterine pathologies in an office setting without anaesthesia. Experimentation of a special set-up of the electrical generator reduced patient discomfort during the operative part of the hysteroscopic procedure.