LAUSR

Study Objective To evaluate the safety and effectiveness of operative hysteroscopy for management of retained products of conception (RPOC) Design Retrospective chart review. Setting Operating room of a gynecology endoscopy unit of a large community center. Patients or Participants Patients who underwent hysteroscopic removal of RPOCs between November 1, 2008 and December 31, 2017 performed by a single physician. Interventions Hysteroscopic removal of retained products of conception performed in the operating room under general anesthesia. Cases were categorized with RPOC type 0 to 3 according to the vascularity of the retained tissue noted on Doppler vaginal ultrasound as per the Gutenberg classification of RPOC. Measurements and Main Results Forty-five (n=45) patients met inclusion criteria. The average age was 35.9 years of age (SD: 4.45). The preceding pregnancy resulting in retained POCs was abortion comprising 64.4% (n=29) followed by vaginal deliveries (13.3%, n=6) and cesarean (11.1%, n=5). Groups were divided into low vascularity group (Type 0 and 1 of the Gutenberg classification, NV Group) and moderate to high vascularity group (Type 2 and 3 of the Gutenberg classification, HV Group). 37.9% of patients of the NV Group had previous treatment compared to 62.5% of the HV Group (p Conclusion Hysteroscopic removal of RPOC is a highly effective and safe surgical procedure. The use of electrosurgical energy is frequently needed to obtain hemostasis in the presence of highly vascular RPOC. Physicians should ensure the capacity to use electrosurgical energy to avoid intraoperative complications when performing removal of highly vascular RPOCs.