AlphaScope vs Lens-Based Hysteroscope for Office Polypectomy without Anesthesia: Randomized Controlled Study

Cicinelli, Ettore; Tinelli, Raffaele; Loiudice, L; Loiudice, I.; Quattromini, P.; Cicinelli, Mv; Pinto, Vincenzo

doi:10.1016/j.jmig.2011.08.009

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…IV sedation Cicinelli et al [19] 2011 Women with a sonographically diagnosed endometrial polyp <2 cm in the follicular phase (day 5 −11) of the menstrual cycle 5 Fr Versapoint bipolar electrode passed through a 3.5-mm Versascope (total diameter 5.2-mm) for polyp resection. 7Fr forceps used for polyp extraction (total diameter increased to 5.8 mm).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Versapoint) against resectoscopy [13], mechanical morcellation (using Truclear) [15,16], and diode laser resection [18]. One study compared Versascope expanded to 5.8 mm with 7Fr forceps against a 5-mm lens-based hysteroscope with integral working channel accommodating 5Fr forceps [19]. Another study compared different methods of polyp retrieval, comparing a specially manufactured "isterobasket" against traditional tissue-retrieval instruments (e.g., 5F forceps) [20].…”

Section: Pain and Operative Technologies Used In Office Hysteroscopymentioning

confidence: 99%

“…Six studies displayed no concerns regarding study conduct [13,15,17,19,21,22]; however, 1 showed "some concerns [18]," and 3 were considered at "high risk" of bias [14,16,20]. In the one study that displayed "some concerns," this was because of a lack of detail regarding the randomization process.…”

Section: Study Biasmentioning

confidence: 99%

“…Women found that the use of the Versascope system (3.5-mm diameter) with 7Fr forceps (increasing the total diameter to 5.8-mm) significantly less painful than a lensbased hysteroscope with 5Fr forceps (total diameter 5-mm) for polypectomy (p <.05), even though average procedural time was longer (6.9 minutes vs 5.1 minutes) [19]. The incidence of adverse events was small and balanced between groups (p = .09) [19]. Polyp extraction was significantly less painful (p = .01) and quicker (p = .005) using an "isterobasket" when compared with traditional ancillary hysteroscopic instruments [20].…”

Section: Endometrial Polypectomymentioning

confidence: 99%

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Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Silva

Stevenson

Smith

et al. 2021

Journal of Minimally Invasive Gynecology

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To identify technologies associated with the least operative pain in women undergoing operative office hysteroscopic procedures. Data Sources: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials were searched until January 2021 using a combination of keywords "hysteroscop*," "endometrial ablation," "outpatient," "ambulatory," "office," and associated Medical Subject Headings. Methods of Study Selection: Randomized controlled trials evaluating the effect of hysteroscopic devices on pain experienced by women undergoing operative office hysteroscopy were included. Data were also collected regarding efficacy, procedural time, adverse events, and patient/clinician acceptability and/or satisfaction. Tabulation, Integration, and Results: The search returned 5347 records. Ten studies provided data for review. Two trials compared endometrial ablation using bipolar radiofrequency with thermal balloon energy, with no significant difference in pain observed (p <.05). Seven trials evaluated technologies for endometrial polypectomy, of which, 4 compared energy modalities: miniature bipolar electrode resection against resectoscopy (N = 1), morcellation (N = 2), and diode laser resection (N = 1). Two studies compared hysteroscope diameter, and one study compared methods of polyp retrieval. A significant reduction in pain was found using morcellators rather than miniature bipolar electrosurgical devices (p <.001), 22Fr rather than 26Fr resectoscopes (p <.001), and 3.5-mm fiber-optic hysteroscopes with 7Fr forceps rather than 5-mm lens-based hysteroscopes with 5Fr forceps (p <.05). One study investigating septoplasty showed significant reduction in pain when cold mini-scissors, rather than a miniature bipolar electrode, were used (p = .013). Average procedural times ranged from 5 minutes 28 seconds to 22 minutes. The incidence of adverse events was low, and data regarding efficacy and acceptability/satisfaction were limited. Conclusion: Pain is reduced when mechanical technologies such as morcellators and scissors are used compared with electrical devices for removing structural lesions in the office. For hysteroscopic and ablative procedures, smaller and quicker devices are less painful. Large-scale RCTs investigating patient pain and experience with modern operative devices in the office setting are urgently needed.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Pain and Operative Technologies Used In Office Hysteroscopymentioning

confidence: 99%

Section: Study Biasmentioning

confidence: 99%

Section: Endometrial Polypectomymentioning

confidence: 99%

See 2 more Smart Citations

Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Silva

Stevenson

Smith

et al. 2021

Journal of Minimally Invasive Gynecology

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show abstract

“… 48 There are various different mechanical and electrosurgical techniques that can be used to perform endometrial polypectomy in an outpatient setting. 49 , 50 These include fine scissors and grasping forceps (ideally suited for small solitary lateral wall polyps), bipolar electrodes for rapid cutting of larger polyps followed by graspers/polyp snares to retrieve the specimen and more recently, hysteroscopic morcellators with inbuilt tissue retrieval systems (best suited for large/fundal/multiple polyps). Outpatient polypectomy has been shown to be more cost-effective than inpatient polypectomy.…”

Section: Ah and Treatment Of Aubmentioning

confidence: 99%

Management of abnormal uterine bleeding – focus on ambulatory hysteroscopy

Kolhe¹

2018

IJWH

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The rapid evolution in ambulatory hysteroscopy (AH) has transformed the approach to diagnose and manage abnormal uterine bleeding (AUB). The medical management in primary care remains the mainstay for initial treatment of this common presentation; however, many women are referred to secondary care for further evaluation. To confirm the diagnosis of suspected intrauterine pathology, the traditional diagnostic tool of day case hysteroscopy and dilatation and curettage in a hospital setting under general anesthesia is now no longer required. The combination of ultrasound diagnostics and modern AH now allows thorough evaluation of uterine cavity in an outpatient setting. Advent of miniature hysteroscopic operative systems has revolutionized the ways in which clinicians can not only diagnose but also treat menstrual disorders such as heavy menstrual bleeding, intermenstrual bleeding and postmenopausal bleeding in most women predominantly in a one-stop clinic. This review discussed the approach to manage women presenting with AUB with a focus on the role of AH in the diagnosis and treatment of this common condition in an outpatient setting.

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Clinical evaluation of a new hand-driven hysteroscopic tissue removal device, Resectr™ 5fr, for the resection of endometrial polyps in an office setting

Wessel

Hamerlynck

Vliet

et al. 2023

Arch Gynecol Obstet

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AlphaScope vs Lens-Based Hysteroscope for Office Polypectomy without Anesthesia: Randomized Controlled Study

Cited by 9 publications

References 11 publications

Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Management of abnormal uterine bleeding – focus on ambulatory hysteroscopy

Clinical evaluation of a new hand-driven hysteroscopic tissue removal device, Resectr™ 5fr, for the resection of endometrial polyps in an office setting

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AlphaScope vs Lens-Based Hysteroscope for Office Polypectomy without Anesthesia: Randomized Controlled Study

Cited by 9 publications

References 11 publications

Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Pain and Operative Technologies Used in Office Hysteroscopy: A Systematic Review of Randomized Controlled Trials

Management of abnormal uterine bleeding &ndash; focus on ambulatory hysteroscopy

Clinical evaluation of a new hand-driven hysteroscopic tissue removal device, Resectr™ 5fr, for the resection of endometrial polyps in an office setting

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Product

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Management of abnormal uterine bleeding – focus on ambulatory hysteroscopy