A prospective study of the use of the Myosure resectoscope to manage endometrial polyps in an outpatient setting

Abstract

Background: The Myosure resectoscope has been in use since 2009. Our unit is the first in Australia to describe the use of the Myosure device in the outpatient setting to resect endometrial polyps. Aim: To compare patient satisfaction and pain scores of pre-and postmenopausal women undergoing outpatient removal of endometrial polyps using the Myosure device. Material and Methods: Public hospital based prospective study. Patients (n=42) who opted to have resection of endometrial polyps under local anaethesia were recruited. Procedures were performed using a 6.25-mm hysteroscope with a MyoSure Lite device. Patient experiences were collected using a questionnaire immediately postprocedure. Pain level was assessed using 100-mm visual analogue score (VAS). Resection times and untoward events were recorded. Results: Mean endometrial polyp size was 13 mm and the mean resection time was 39.4s. Complete resection was achieved in 95.2% of cases. The median VAS was 2.7 (range 0.7-7.5). The pain scores did not differ significantly between nulliparous or parous women who only had a caesarean section delivery and those who have delivered vaginally. However, VAS was statistically less in postmenopausal women in comparison with premenopausal women (2.5 vs 3.2, respectively; (P = 0.047)). Overall, women were very satisfied; 97.6% would recommend the procedure to a friend and 95.2% happy to consider a repeat procedure in the future if required. The complication rate was 4.8%, and all were minor in nature. Conclusion: Operative hysteroscopic procedures can be performed successfully in the outpatient setting using the Myosure Lite device with a high level of patient satisfaction.

Patient acceptability and satisfaction for hysteroscopic morcellation

“…This is in contrast to most findings that suggest that postmenopausal status is related to a higher pain score in hysteroscopy, which is attributed to a tighter cervical os and vaginal dryness from a hypo-oestrogenic state 15 . However, our results are in line with those in a study that reported significantly higher pain scores in premenopausal women than in postmenopausal women (3.2 vs 2.5, p=0.047) who underwent removal of endometrial polyps in an outpatient setting using the MyoSure morcellation device 16 . One explanation for this observation may be that pain receptors in the cervix or uterus are more sensitive in premenopausal women, and that the co-existence of adenomyosis, fibroids, and chronic inflammatory pelvic conditions is more common in premenopausal women 17 .…”

Audit of operative hysteroscopies among infertile women in a resource‐poor setting

“…In the present series, a day case theater setting was used because the hospitals have yet to acquire the capacity and required skills for outpatient operative hysteroscopy. Various tools are available for the resection of polyps, including a monopolar loop electrode, scissors and graspers, bipolar systems, laser systems, a mechanical energy system, morcellators, and tissue‐assimilation systems . In the present series, a combination of scissors, graspers, and monopolar resectoscope was used.…”

Hysteroscopic Surgery for Submucosal Fibroids

“…Increasingly over the last decade, more operative hysteroscopic procedures have been performed in an office-based setting. Mcilwaine et al showed in a study of 42 patients that the Myosure lite device (uses electromechanical energy) can be successfully used to resect small fibroids in the outpatient setting with a high level of patient satisfaction with the use of local anaesthetic in a paracervical block [40].…”