The clinical research of different surgical methods under hysteroscopes for endometrial polyps infertility / 中国医师进修杂志

ABSTRACT

Objective To explore the clinical effectiveness of transcervical resection of polyps (TCRP) under hysteroscopes and dilatation and curettage in treatment for endometrial polyps infertility.Methods Ninety patients with endometrial polyps infertility from October 2010 to August 2012 were enrolled in this study.In them,45 patients were treated with TCRP under hysteroscopes (TCRP group),45 patients were treated with dilatation and curettage (dilatation and curettage group).Patients were followed up for 1 year,menstrual blood volume and endometrial thickness in ovulatory before operation and after operation for 3,6 and 12 months were recorded and compared between two groups.While the recurrence rate after operation for 6,12 months and 1-year pregnancy rate were also recorded and compared between two groups.Results The menstrual blood volume and endometrial thickness in ovulatory before operation between two groups had no significant difference (P ＞ 0.05).The menstrual blood volume after operation for 3,6 and 12 months in TCRP group was (125.2 ±56.4),(154.0 ±72.3) and (189.8 ±96.6) ml,respectively.While in dilatation and curettage group was (215.3 ± 87.8),(267.5 ± 98.4) and (297.5 ± 125.6) ml.There were significant differences (P ＜ 0.05 or ＜ 0.01).The endometrial thickness in ovulatory after operation for 3,6 and 12 months in TCRP group was significantly lower than that in dilatation and curettage group (P ＜ 0.05 or ＜ 0.01).The recurrence rate after operation for 6,12 months and 1-year pregnancy rate in TCRP group was 4.4％ (2/45),8.9％ (4/45)and 20.0％ (9/45) ; in dilatation and curettage group was 8.9％ (4/45),35.6％(16/45) and 26.7％ (12/45).The recurrence rate after operation for 12 months in TCRP group was significantly higher than that in dilatation and curettage group (P ＜0.01).Conclusions The prospective efficacy of TCRP under hysteroscopes in treatment of endometrial polyps infertility is better than dilatation and curettage.It is one of better methods and worthy to spread.