New insights in the hysteroscopic treatment of intrauterine pathology

In this study we look at the treatment of three common abnormalities that can occur on the
inside of the uterus, or womb. These are polyps (i.e. a swelling of the inner lining of the
womb), myomas (i.e. a benign tumor of the muscular wall of the womb) and residual
placental tissue (i.e. a remainder of the afterbirth in the womb). Hysteroscopy is a technique
where a small camera is used to look inside the womb. It has a working channel through
which an instrument can be introduced to remove abnormalities. The classic technique used is
the resectoscope that has a curved wire on which electrical current can be applied to cut and
remove abnormalities. A more recent technique is the hysteroscopic morcellator (HM), which
is a sort of shaving device, that aspirates and cuts of the abnormalities. We compare both
techniques in a prospective, randomized trial for the removal of intrauterine polyps, smaller
myomas, and residual placental tissue. Adult women with one of these abnormalities are
randomly assigned to be treated with one of the techniques. The main study endpoints are
installation and operating time. Moreover we look at the risk of adhesion formation in the
womb after the operation by performing a U+2018second lookU+2019 hysteroscopy in the office. This is
important as intrauterine adhesions can influence patientU+2019s fertility. Based on previous data it
is expected that the HM beholds some advantages over the resectoscope, such as shorter
operating time and less complications.