Cooper Natalie A M, Middleton Lee, Smith Paul, Denny Elaine, Stobert Lynda, Daniels Jane, Clark T Justin
Women's Health Research Unit, Queen Mary University of London, London, E1 2AT UK.
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, B15 2TT UK.
Gynecol Surg. 2016;13(4):313-322. doi: 10.1007/s10397-016-0946-4. Epub 2016 May 17.
Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.
子宫内膜息肉可导致女性异常出血。传统做法是在全身麻醉下切除息肉,但技术进步使得在门诊进行息肉切除术成为可能。我们开展了一项患者偏好研究,以探究女性对治疗环境的偏好,并评估接受子宫内膜息肉切除术的女性的治疗效果及治疗体验。招募了399名在诊断性宫腔镜检查中发现有子宫内膜息肉且存在子宫异常出血的女性。门诊息肉切除术在门诊宫腔镜检查诊所进行,住院手术则在手术室进行。399名患者中有324名(81%)表示倾向于门诊治疗。在患者评估的缓解子宫异常出血方面以及改善疾病特异性生活质量方面,门诊治疗和住院治疗之间未发现差异。门诊组的可接受性较低,患者疼痛评分显著更高。当为子宫内膜息肉切除术提供治疗环境选择时,患者更倾向于门诊治疗而非住院治疗。医疗保健系统应提供门诊妇科服务以满足患者需求。