[Hysteroscopic morcellation versus bipolar resection for endometrial polyp removal]. / Morcellement hystéroscopique versus résection à l'anse bipolaire pour les polypes endométriaux.

OBJECTIVE: The treatment of endometrial polyps is based on hysteroscopic resection. The aim of the current study was to compare the results associated with hysteroscopic morcellation and those observed with bipolar loop resection. PATIENTS AND METHODS: A single-center observational retrospective comparative study was performed, including 25 patients who underwent hysteroscopic resection of endometrial polyps from January 2012 to December 2013. The mean size of polyp was 9.2 mm in the group compared to 12.5mm in the resection group loop (P=0.06). RESULTS: Twelve patients underwent resection of the polyp morcellation with MyoSure(®) and 13 with bipolar resection loop Versapoint(®) 24F. The mean operative time was 16 minutes in morcellation group and 17 minutes in the bipolar resection group (P=0.76). Complete removal was achieved in 100% of cases in morcellation group and in bipolar loop resection. Regarding intraoperative and postoperative complications, no complication was observed in the two groups. DISCUSSION AND CONCLUSION: Results associated with hysteroscopic morcellation and bipolar loop resection seen to be comparable.

[Operative hysteroscopy for myoma removal: Morcellation versus bipolar loop resection]. / Hystéroscopie opératoire pour fibrome : morcellement versus résection à l'anse bipolaire.

OBJECTIVE: To evaluate the results associated with hysteroscopic morcellation for submucous myomas removal, and to compare with those observed associated with bipolar loop resection. MATERIELS AND METHODS: A retrospective comparative study was conducted in two universitary centers from January 2012 to December 2013. A total of 83 patients, who presented with submucous myomas type 0,1 and 2, were included. The number of myomas type 0,1 was 36 (71 %) and 15 (29 %) myomas type 2 in morcellation group versus 44 (59 %) myomas type 0,1 and 31 (41 %) type 2 in electrosurgical resection group (P=0.17). Hysteroscopic morcellation or electrosurgical resection with bipolar loop for removal submucous myomas were performed. RESULTS: Thirty-four patients underwent hysteroscopic morcellation using MyoSure(®), and 49 had hysteroscopic resection using Versapoint-24F(®) bipolar loop. The mean operative duration was 30minutes in morcellation group, compared to 31minutes in bipolar resection group (P=0.98). Complete myoma removal was achieved in 22 (64 %) patients in morcellation group, and in 34 (69 %) in bipolar resection group (P=0.65). There were no difference in the occuring of adverse events between the two. The prevalence of postoperative intra-uterine adherence was 10 % in morcellation group and 13.8 % in bipolar resection group (P=0.69). CONCLUSION: In the current short comparative series, hysteroscopic morcellation and bipolar loop resection were associated with comparable results for removal of submucous myomas.

[Incarceration of the retroverted uterus in the third trimester: report of 2 cases]. / Rétroversion utérine persistante au troisième trimestre : à propos de 2 cas.

Incarceration of the retroverted gravid uterus in the third trimester is a rare but distinctive diagnosis. Initial symptoms are more frequently urinary and digestive symptoms which became more acute at the third trimester. Severe abdominal pain associated with bleeding in early labor leads to make the diagnosis during an emergency cesarean section. However, the typical features of the clinical transvaginal exam and the abdominal ultrasound exam can confirm easily this diagnosis. We report two additional cases where Joël-Cohen incision for cesarean section was possible after manual reposition of the uterus. We discuss the diagnostic approach and the management regarding a literature review.