CLINICAL EFFICIENCY OF HYSTERO-RESECTOSCOPY IN THE TREATMENT OF PLACENTAL POLYPS

Objective. To optimize surgical techniques for the treatment of placental polyps via hystero-resectoscopy. Subjects and methods. The results of clinical and morphological examinations and endosurgical treatment were retrospectively analyzed in 38 patients treated for placental polyp in the Gynecology Clinic, S.P. Botkin Moscow City Clinical Hospital in 2011-2012. Results. According to pregnancy outcomes, the patients were divided into 3 groups: 1) 18 (47.3%) patients after artificial abortion (pharmacological abortion [n=12 (31.6%)]; artificial medical abortion [n=6 (15.7%)]); 2) 9 (23.6%) patients after non-developing pregnancy; 3) 11 (28.9%) patients after spontaneous labor. Thirty-one (81.5%) patients underwent hystero-resectoscopic polypectomy, by using resection and coagulation monopolar electrosurgical procedures, 7 (18.4%) patients had targeted loop polyp removal without energizing. Hysteroresectoscopy could determine the exact location, the nature of the polyp base, the state of the endometrium, and the presence of another intrauterine abnormality. Surgery lasted from 10 to 20 minutes. The placental polyp was completely removed in all the patients. There were no intraoperative complications in any case. In all the patients, the diagnosis of placental polyp was morphologically verified. The dynamic evaluation of the clinical signs of the disease and laboratory parameters was a criterion for treatment effectiveness. The patients were discharged on days 1-2 after surgery (maximally on day 3. Conclusion. Hystero-resectoscopy is an effective surgical treatment in patients with placental polyps, can improve the results of treatment for this type of intrauterine pathology, and reduces the risk of massive blood loss and inflammatory complications, the length of hospital stay, and the number of days of total disability.

placental polyp, hystero-resectoscopy, eff iciency