Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment

Objective: To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain referred by patients in both groups. Methods: An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient's hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. Results: The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps > 1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. Conclusion: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.