Excision of Endocervical Polyps Under Local Anesthesia in Rural Hospitals: A Case Series

Abstract

Abstract

Objectives: The aims of this study were (1) to assess the effectiveness of endocervical polypectomy and patient satisfaction when using local prostaglandins for endocervical dilatation and bupivacaine for anesthesia; and (2) to explore the histopathology of resected specimens and endometrial curetting samples. Design: This prospective, uncontrolled, open-label study was conducted in district hospitals of the Kashmir division in India over a 2-year period between May 2013 and May 2015. Materials and Methods: A total of 22 patients were included in the study; they had symptoms of intermenstrual bleeding, dyspareunia, and vaginal discharge. Pregnant females were excluded. Efficacy endpoints, such as patient satisfaction, histopathology of resected specimens and endometrial curetting samples, and complications during the procedure or local anesthesia, were evaluated. Results: The majority of woman was premenopausal (63.6%), and the remainder were postmenopausal (36.3%). The majority of the polyps were sessile (90.9%), and histopathology testing showed that all of the polyps were benign. The majority of the patients (77.7%) had simple and nonatypical endometrial hyperplasia per their curetted samples. The majority of the patients (95.4%) tolerated the procedure well, and it was abandoned in 1 patient (4.5%) in favor of general anesthesia. No intraoperative complications occurred. Total polypectomy was performed in all patients. Conclusions: Endocervical polypectomy can be performed successfully in outpatient settings, with minimal intraoperative discomfort for patients where limited resources exist. Meeting patient preferences for faster recovery and less time away from their families are additional, cost-effective advantages. (J GYNECOL SURG 32:158)