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McEvoy A, Aboseif C, Fogel J, Alles A, Khutti S, Kapoor U, Saad A. Sharp Versus Electric Suction Curettage in Gynecologic Patients Undergoing Evaluation for Abnormal Uterine Bleeding. J Minim Invasive Gynecol 2023; 30:983-989. [PMID: 37661082 DOI: 10.1016/j.jmig.2023.08.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/11/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
STUDY OBJECTIVE Suction curettage is preferred over sharp curettage in obstetric settings. We compare the quality of operative tissue sampling between sharp curettage and suction curettage using electric vacuum aspiration for nonobstetric abnormal uterine bleeding in reproductive-aged women. DESIGN A retrospective cohort study. SETTING Community hospital in Long Island, New York. PATIENTS Women ages 21 to 45 years (n = 257) who underwent operative curettage procedure for nonobstetric abnormal uterine bleeding. INTERVENTIONS Independent ratings of specimens from suction curettage using electric vacuum aspiration and sharp curettage by 2 pathologists blinded to method of tissue collection. MEASUREMENTS AND MAIN RESULTS The primary outcome was percentage of organized tissue, indicative of a higher-quality pathology specimen. Specimens obtained by electric suction curettage (p <.001) had a significantly higher percentage of organized tissue (M = 66.28, SD = 20.33) than sharp curettage (M = 55.51, SD = 24.17). There were no differences between the curettage groups for operative time, blood loss, intraoperative complications, or pathology diagnosis. CONCLUSION Specimens obtained with suction curettage contained more organized tissue with similar pathologist satisfaction and confidence scores than sharp curettage. We suggest clinicians consider electric suction curettage in the diagnostic workup of abnormal uterine bleeding in reproductive-aged women. In addition, patient-centered benefits include no increase in operative time, blood loss, or complication rate compared with sharp curettage.
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Affiliation(s)
- Austin McEvoy
- Department of Obstetrics and Gynecology (Drs. McEvoy, Aboseif, and Fogel), Nassau University Medical Center, East Meadow, NY
| | - Christine Aboseif
- Department of Obstetrics and Gynecology (Drs. McEvoy, Aboseif, and Fogel), Nassau University Medical Center, East Meadow, NY
| | - Joshua Fogel
- Department of Obstetrics and Gynecology (Drs. McEvoy, Aboseif, and Fogel), Nassau University Medical Center, East Meadow, NY; Department of Business Management (Dr. Fogel), Brooklyn College of the City University of New York, Brooklyn, NY
| | - Ajit Alles
- Department of Pathology and Laboratory Medicine (Drs. Alles, Khutti, and Kapoor), Northwell Health, Massapequa, NY
| | - Seema Khutti
- Department of Pathology and Laboratory Medicine (Drs. Alles, Khutti, and Kapoor), Northwell Health, Massapequa, NY
| | - Urvashi Kapoor
- Department of Pathology and Laboratory Medicine (Drs. Alles, Khutti, and Kapoor), Northwell Health, Massapequa, NY
| | - Andre Saad
- Director Minimally Invasive Gynecology (Dr. Saad), Northwell Health, Plainview, NY.
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Nishioka M, Maezawa T, Takeuchi H, Hagiwara K, Tarui S, Sakamoto M, Takayama E, Yajima H, Kondo E, Kawato H, Minoura H, Sugaya K, Fukuda A, Ikeda T. Pregnancy Rates after Hysteroscopic Endometrial Polypectomy versus Endometrial Curettage Polypectomy: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1868. [PMID: 37893586 PMCID: PMC10608414 DOI: 10.3390/medicina59101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/02/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: A relationship between endometrial polypectomy and in vitro fertilization (IVF) pregnancy outcomes has been reported; however, only a few studies have compared polyp removal techniques and pregnancy rates. We investigated whether different polypectomy techniques with endometrial curettage and hysteroscopic polypectomy for endometrial polyps affect subsequent pregnancy outcomes. Materials and Methods: Data from 434 patients who had undergone polypectomy for suspected endometrial polyps using transvaginal ultrasonography before embryo transfer in IVF at four institutions between January 2017 and December 2020 were retrospectively analyzed. Overall, there were 157 and 277 patients in the hysteroscopic (mean age: 35.0 years) and curettage (mean age: 37.3 years) groups, respectively. Single-blastocyst transfer cases were selected from both groups and age-matched to unify background factors. Results: In the single-blastocyst transfer cases, 148 (mean age: 35.0 years) and 196 (mean age: 35.9 years) were in the hysteroscopic and curettage groups, respectively, with the 148 cases matched by age. In these cases, the pregnancy rates for the first embryo transfer were 68.2% (odds ratio (OR): 2.14) and 51.4% (OR: 1.06) in the hysteroscopic and curettage groups, respectively; the resulting OR was 2.03. The pregnancy rates after up to the second transfer were 80.4% (OR: 4.10) and 68.2% (OR: 2.14) in the hysteroscopic and curettage groups, respectively, in which the OR was 1.91. The live birth rates were 66.2% (OR: 1.956) and 53.4% (OR: 1.15) in the hysteroscopic and curettage groups, respectively, in which the odds ratio was 1.71. These results show the effectiveness of hysteroscopic endometrial polypectomy compared to polypectomy with endometrial curettage. No significant difference was found regarding the miscarriage rates between the two groups. Conclusions: Hysteroscopic endometrial polypectomy resulted in a higher pregnancy rate in subsequent embryo transfer than polypectomy with endometrial curettage. Therefore, establishing a facility where polypectomy can be performed hysteroscopically is crucial.
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Affiliation(s)
- Mikiko Nishioka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Tadashi Maezawa
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Katsuyuki Hagiwara
- Faculty of Education, Mie University, 1577 Kurima-Machiya-cho, Tsu, Mie 514-8507, Japan;
| | - Sachiyo Tarui
- Department of Obstetrics and Gynecology, IVF Osaka Clinic, 1-1-14 Nagatahigashi, Higashiosaka, Osaka 577-0012, Japan; (S.T.); (A.F.)
| | - Mito Sakamoto
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Erina Takayama
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Hideaki Yajima
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
| | - Hiroaki Kawato
- Department of Obstetrics and Gynecology, Kawato Ladies Clinic, 1-16-11 Betsumei, Yokkaichi, Mie 510-0007, Japan;
- Department of Obstetrics and Gynecology, Minoura Ladies Clinic, 3-9-17 Isoyama, Suzuka, Mie 510-0256, Japan;
| | - Hiroyuki Minoura
- Department of Obstetrics and Gynecology, Minoura Ladies Clinic, 3-9-17 Isoyama, Suzuka, Mie 510-0256, Japan;
| | - Ken Sugaya
- Department of Obstetrics and Gynecology, Saiseikai Matsusaka General Hospital, 15-6 asahimachiichiku, Matsusaka, Mie 515-8557, Japan;
| | - Aisaku Fukuda
- Department of Obstetrics and Gynecology, IVF Osaka Clinic, 1-1-14 Nagatahigashi, Higashiosaka, Osaka 577-0012, Japan; (S.T.); (A.F.)
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan; (M.N.); (H.T.); (M.S.); (H.Y.); (E.K.); (T.I.)
- Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan;
- Center of Advanced Reproductive Medicine, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan
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