Objective: To reveal the
breadth of experience for the intrauterine morcellator amongst gynecologists in
a single US academic center. Design: Retrospective Descriptive. Setting:
University Hospital. Patients: In total, 33 hysteroscopic procedures, with
intrauterine morcellation, were performed for 28 patients for benign
endometrial disease at Magee―Womens
Hospital at the University of Pittsburgh Medical center between October 2006
and February 2012. Intervention: Operative Hysteroscopy with an intrauterine
morcellator. Measurement and Main Results: The major indication for
hysteroscopic surgery was endometrial polyp (54.5%), followed by intrauterine
fibroids (18.2%), filling defect on sonohysterogram (15.2%), abnormal uterine
bleeding (9.1%), and uterine synechiae (3%). The mean greatest diameter for all
intrauterine pathology resected was 1.14 ± 0.46 cm (Range 0.6 - 1.9 cm), and,
notably, the largest fibroid resected was 1.5 cm in greatest diameter. The
average operative time was 39 ± 29 minutes (range 15 - 122 minutes), and
average hysteroscopic fluid deficit was 286 ± 479.5 mL (range 30 - 2000 mL).
There were only 2 patients for whom the deficit was greater than 1 L, one of
whom underwent a myomectomy with total operative time of 26 minutes, while the
other underwent a hysteroscopic adhesiolysis and had a total operative time of
122 minutes. The complication rate was 6.0%, and complications reported
included uterine perforation (n = 1) and cervical injury (n = 1). Conclusion:
The intrauterine morcellator is a useful tool for surgical treatment of
intrauterine pathology that confers a low operative risk.
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