Using a 16-French Resectoscope as an Alternative Device in the Treatment of Uterine Lesions A Randomized Controlled Trial

OBJECTIVE: To compare a 16-French resectoscope with a 22-French resectoscope and a 15-French hysteroscope for the treatment of uterine cavity lesions. METHODS: This was a prospective, randomized study of women with endometrial polyps or submucous myomas treated with a 16-French resectoscope, a traditional 22-French resectoscope, or a 15-French hysteroscope. The operating time, volume of distension medium delivered, discharge time, and patient discomfort by visual analog scale were recorded. Data were compared by one-way and two-way analysis of variance as appropriate. RESULTS: Four hundred one women were included in the analysis. All four parameters showed lower values in the 16-French resectoscope group (142 women) compared with the 15-French hysteroscope group (132 women; P<.01). The mean operating time was 10.87 +/- 2.87 minutes in the 22-French group (127 women), 8.33 +/- 2.94 minutes in the 16-French group, and 17.11 +/- 6.86 minutes in the 15-French group. The mean volume of distension medium delivered was 1,043 +/- 230 mL in the 22-French group, 991 +/- 442 mL in the 16-French group, and 1,489 +/- 566 mL in the 15-French group. The mean discharge time was 1.99 +/- 0.72 hours in the 22-French group, 1.08 +/- 0.18 hours in the 16-French group, and 1.89 +/- 0.68 hours in the 15-French group. Finally, the mean visual analog scale scores were 2.10 +/- 0.97 in the 22-French group, 1.93 +/- 1.03 in the 16-French group, and 4.00 +/- 1.61 in the 15-French group. An analysis of patients subdivided according to the lesion size (less than 1.5 cm and more than 1.5 cm in diameter) showed similar results. CONCLUSION: The new 16-French resectoscope is effective for the "see and treat" approach for both small (less than 1.5 cm diameter) and large (more than 1.5 cm diameter) uterine lesions. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01430208. (Obstet Gynecol 2012; 120: 160-5) DOI:10.1097/AOG.0b013e31825b9086 LEVEL OF EVIDENCE: I