Clinical outcomes of manual mechanical resection versus electrosurgical resection of endometrial polyps under hysteroscopic guidance:a comparison

QI Xiaoxuan; JIA Jinghui; LI Jingxuan; WANG Hongfang; LIU Lu; LIU Xiaofang

doi:10.3969/j.issn.2097-1753.2025.05.015

Abstract：Objective To compare the clinical effects of manual mechanical hysteroscopic tissue removal(mHTR)and that of hysteroscopic electricity resection(HEC)for the treatment of endometrialpolyps(EMPs).Methods Sixty patients with EMPs admitted to the Air Force Medical Center between August 2022 and February 2024 were enrolled in this study.According to surgical approaches,30 patients treated with the manual mHTR were assigned to the observation group while another 30 patients undergoing hysteroscopic resection served as the control group.The perioperative indicators of the two groups were compared,including the time taken to remove the largest polyp,numbers of times instrument entered the uterine cavity,amounts of bleeding,usage of distention solutions,menstrual recovery,endometrial thickness,maximum polyp volume,postoperative complications(patients with infection and intrauterine adhesions),recurrence(patients with endometrial polyps detected a second time via postoperative ultrasound examination),and pregnancy(patients with confirmed intrauterine pregnancy by postoperative ultrasound).Results The time taken to remove the largest polyp in the observation group was shorter than in the control group(Z=-3.691,P＜0.001).The number of times the hysteroscope entered the uterine cavity and the usage of distention solutions were both lower than those in the control group(Z=-7.125,-2.121,P＜0.001,=0.034).There was no statistically significant difference in the amount of intraoperative bleeding,postoperative menstrual recovery time,or endometrial thickness between the two groups(P＞0.05).All patients were followed up for at least 6 months.There was 1 case of recurrence but no occurrence of intrauterine adhesions in the observation group.Among the 17 married but childless subjects,7 became pregnant.In the control group,there was no recurrence but 1 case of intrauterine adhesion.Among the 14 married and childless individuals,6 became pregnant.Conclusion Both manual mHTR and HEC are effective in the treatment of endometrial polyps.Manual mHTR has some advantages over HEC in that it is portable,safe,effective and causes no electrical heating damage and fewer postoperative complications.Moreover,it does not affect pregnancy and is suitable for young women with both EMPs and fertility needs.