Application of thulium laser for endometrial polyp removal in women of reproductive age

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Abstract

Background: Endometrial polyps are a common gynecological condition, occurring in 10%–24% of women of reproductive age, which often leads to infertility and menstrual disorders. Bipolar resection is considered one of the effective methods of polyp removal; however, it is accompanied by significant pain and prolonged recovery. Among the more effective and less painful approaches, the use of the thulium laser is considered a promising option, having already proven successful in modern urological practice.

Aim: To evaluate the efficacy and safety of thulium laser polypectomy in women of reproductive age.

Methods: The study, which included 46 women with endometrial polyps (23 in each group), compared two methods of polypectomy: thulium laser and bipolar resection. The following parameters were taken into account: procedure duration, pain level, time to menstrual cycle recovery, recurrence rate, and acceptability.

Results: Thulium laser treatment demonstrated shorter operation time (10.04 ± 0.97 min vs 13.86 ± 1.20 min), less pain, faster recovery of menstrual function (28.6 ± 2.9 days vs 34.65 ± 3.06 days), and a lower recurrence rate (8.69% vs 17.39%). Patient acceptability of the thulium laser was also higher (99.39% vs 92.39% at 1 month).

Conclusion: The findings indicate the benefits of thulium laser in the treatment of endometrial polyps and highlight the need for further studies to assess its long-term outcomes.

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About the authors

Yulia E. Dobrokhotova

Pirogov Russian National Research Medical University

Email: Pr.Dobrohotova@mail.ru
ORCID iD: 0000-0002-7830-2290
SPIN-code: 2925-9948

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 1 Ostrovityanov st, Moscow, 117997

Irina A. Lapina

Pirogov Russian National Research Medical University; Clinical Hospital № 2 “Medsi”

Author for correspondence.
Email: doclapina@mail.ru
ORCID iD: 0000-0002-2875-6307
SPIN-code: 1713-6127

MD, Dr. Sci. (Medicine)

Russian Federation, 1 Ostrovityanov st, Moscow, 117997; Moscow

Ayshan R. Allakhverdieva

Pirogov Russian National Research Medical University; Clinical Hospital № 2 “Medsi”

Email: allakhverdievaayshan@gmail.com
ORCID iD: 0000-0001-8693-5867
SPIN-code: 3958-5660
Russian Federation, 1 Ostrovityanov st, Moscow, 1179974; Moscow

Olesya V. Kaykova

Clinical Hospital № 2 “Medsi”

Email: kajkova.ov@medsigroup.ru
ORCID iD: 0009-0007-3931-5762
Russian Federation, Moscow

References

  1. Clinical Guidelines “Endometrial Polyps” (approved by the Ministry of Health of the Russian Federation). Russian Society of Obstetricians and Gynecologists. Moscow, 2023. 32 p. (In Russ.) URL: http://disuria.ru/_ld/12/1289_kr23N84p0MZ.pdf
  2. Orazov MR, Khamoshina MB, Poimanova OF, et al. Clinical and anamnestic factors of recurrent endometrial polyps in fertile age. Clinical Review for General Practice. 2023;4(9):31–35. doi: 10.47407/kr2023.4.9.00305 EDN: FFVZCF
  3. Safronov OV, Kazachkova EA, Kazachkov EL, et al. Prevalence rate and structure of minimally invasive surgical intrauterine pathology in the light of pathomorphosis theory. Ural Medical Journal. 2020;(3):65–70. doi: 10.25694/URMJ.2020.03.38 EDN: UOFLIO
  4. Khusid JA, Khargi R, Seiden B, et al. Thulium fiber laser utilization in urological surgery: A narrative review. Investig Clin Urol. 2021;62(2):136–147. doi: 10.4111/icu.20200467
  5. Rice P, Somani BK. A systematic review of thulium fiber laser: applications and advantages of laser technology in the field of urology. Res Rep Urol. 2021;13:519–527. doi: 10.2147/RRU.S233979
  6. Noureldin YA, Kallidonis P, Liatsikos EN. Lasers for stone treatment: how safe are they? Curr Opin Urol. 2020;30(2):130–134. doi: 10.1097/MOU.0000000000000706

Supplementary files

Supplementary Files
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2. Fig. 1. Study design: EP – endometrial polyps.

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3. Fig. 2. Distribution of symptoms of endometrial polyps in the studied patients.

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4. Fig. 3. Removal of an endometrial polyp using the FiberLase U3 thulium laser with the base located along the left uterine rib. The yellow arrow indicates complete removal of the polyp stalk.

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5. Fig. 4. Distribution of endometrial polyp types by groups.

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6. Fig. 5. Localization of polyps in the uterine cavity.

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7. Fig. 6. Distribution of polyp localization by groups.

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