Patient acceptability and satisfaction for hysteroscopic morcellation
Keywords:
Hysteroscopy, Morcellation, Patient satisfaction, Safety, Treatment outcomeAbstract
Objective: To evaluate patients’ pain scores and satisfaction with hysteroscopic morcellation service in two hospitals in Hong Kong.
Methods: Medical records of women who underwent hysteroscopic morcellation as a day procedure using the Intrauterine Bigatti Shaver between 1 November 2018 and 31 October 2022 at Tuen Mun Hospital or Pok Oi Hospital were retrospectively reviewed.
Results: 242 patients who underwent hysteroscopic morcellation were included. The mean patient age was 54.1 years. Postmenopausal bleeding was the commonest presenting symptom (48.8%), followed by abnormal menstrual bleeding (42.6%). 43.8% of patients had one lesion; 87.2% of patients had endometrial polyps. There were 523 endometrial polyps and 29 myomas; 99.4% of endometrial polyps and 79.3% of myomas were removed. The complete resection rate was higher for patients with endometrial polyps than for patients with myomas (98.7% vs 77.8%, p<0.001). Most patients reported mild pain intraoperatively (57.4%), immediately after the procedure (72.3%), and upon discharge (95.0%). 98.8% of patients were satisfied with the procedure; 94.2% would undergo the same operation again if clinically indicated; and 95.5% would recommend this procedure to others. Premenopausal women reported more pain immediately after the procedure (2 vs 1, p=0.020) and upon discharge (0 vs 0, p=0.040) than postmenopausal women. Patients with an operative time of >20 minutes reported more pain immediately after the procedure (3 vs 1, p=0.007) than patients with an operative time of ≤20 minutes.
Conclusion: Almost all patients were satisfied with hysteroscopic morcellation. Most patients experienced only mild pain during and immediately after the procedure and upon discharge. Premenopausal status and operative time of >20 minutes were associated with higher pain scores. Further optimisation of pain-relief methods should be considered.
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