Office intrauterine morcellation for retained products of conception

• Published in: Minimally invasive therapy and allied technologies Vol. ahead-of-print; no. ahead-of-print; pp. 1 - 6
• Main Authors: Damiani, Gianluca Raffaello, Di Gennaro, Daniele, Vimercati, Antonella, Cicinelli, Ettore, Perrone, Anna Myriam, De Iaco, Pierandrea, Malvasi, Antonio, Gaetani, Maria, Cascardi, Eliano, Cazzato, Gerardo, Dellino, Miriam, Pellegrino, Antonio, Vitagliano, Amerigo
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01-12-2023
• Subjects: Hysteroscopic morcellator; myosure; placenta lesions; placenta remnants; placenta residues; retained products of conception; trophoblastic residues; truclear; Hysteroscopic morcellator; placenta lesions; retained products of conception; trophoblastic residues; myosure; truclear; placenta remnants; placenta residues
• ISSN: 1364-5706; 1365-2931
• DOI: 10.1080/13645706.2023.2227694

Proposing hysteroscopic morcellation (HM) as a surgical-therapeutic approach in the treatment of retained products of conception (RPOC) to prevent intrauterine adhesions (IUAs).
Prospective analysis.
A teaching and university hospital.
Women with RPOC.
Office -HM with 'Truclear 5 C'.
Twenty-two consecutive patients presenting with trophoblastic residue retention after miscarriage and interruption of pregnancy or placenta remnants after cesarean section or delivery were enrolled. These women underwent office-HM with 'Truclear 5 C'. Primary outcomes were median time and rate of hospitalization. The quality of the specimen was also analyzed. A hysteroscopic second look for IUAs was performed.
Mean procedure time was six minutes (SD ± 5). Tissue samples had a mean collection size 2.5 cm
3
+0.9. 38% of the samples had spotting or abnormal vaginal discharge. Dilatation of the cervical canal was not performed in any case. Second-look hysteroscopy did not show any de novo IUAs in any of the enrolled patients.
In the hysteroscopic treatment of RPOC, HM is a valid choice in an office setting without the use of cervical dilatation. Removal of RPOC was uneventful in all cases, simple and carried out faster without any adverse outcomes.