Randomized study comparing a reusable morcellator to a resectoscope in the hysteroscopic treatment of uterine polyps: The RESMO study.

Abstract Study Objective To compare a reusable hysteroscopic morcellator and standard resectoscopes in the hysteroscopic management of uterine polyps. Design Single-center randomized prospective single-blind trial (RESMO Study). Setting CMCO teaching hospital, Strasbourg University Hospitals, France Patients All patients presenting a single endometrial polyp of size greater than or equal to a centimeter. Interventions After consent, patients were randomized into two groups: hysteroscopic morcellator (HM) or standard resection group (SR). Office-based review hysteroscopy was performed 6 to 8 weeks after surgery. Primary endpoint: time of morcellation or resection. Secondary outcomes: total operating time (min), volume of fluid used (mL), fluid deficit (mL), number of morcellator or resectoscope insertions, operator comfort (Visual Analogic Scale VAS: 0 to 10) and quality of vision (0 to 5), perioperative complications, completeness of resection, need to convert to another technique, pain assessment (VAS), and length of hospitalization. At review hysteroscopy, we noted whether resection or morcellation had been effective and if synechiae were present or absent. Statistical analyses followed Bayesian methods. Measurements and Main Results Ninety patients were randomized, 45 in the HM group and 45 in the SR group. The average size of polyps at hysteroscopy was 13.3 mm. Morcellation time was lower than resection time [6.1 vs 9 min; P (HM SR) = 0.999] as was visualization [4 vs 3.7; P (HM>SR) = 0.911, highly probable]. Operative complications were higher in the SR group [5 vs 0; P(HM Conclusion The reusable morcellator is quicker, uses less fluid with less deficit and fewer introductory maneuvers, and offers better comfort and visualization than the resectoscope while being as effective for the hysteroscopic treatment of uterine polyps.