Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: The Hysteroscopic Morcellator Versus the Bipolar Resectoscope for Removal of Lager Intrauterine Polyps, Removal of Submucous Myomas and Removal of Residual Placental Tissue: a Randomized Controlled Trial.
Brief Summary: Rationale:

The hysteroscopic morcellator (HM) is a novel technique for removal of intrauterine polyps, myomas and placental tissue. It withholds some technical advantages over resectoscopy. Previous data suggest that it's a faster technique than the latter, and shows that it has a low complication rate.

Objective:

To compare the HM to bipolar resectoscopy for removal of:

1) large intrauterine polyps, 2) smaller type 0 and 1 myomas, 3) residual placental tissue, in terms of efficiency and complications.

Study design: Single blind, randomized controlled multicenter trial.

Study population: Women aged over 18 years old with:

1) large (≥ 1 cm) intrauterine polyps, 2) smaller (≤ 3 cm) type 0 or 1 myomas, 3) residual placental tissue, who are planned for hysteroscopic removal.

Intervention:

Patients are randomized between removal with the HM or the bipolar resectoscope.

Main study parameters/endpoints:

Installation and operating time.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

Women who are referred to our polyclinic will be seen on a first visit, and, according to the standard work-up, an ultrasound will be performed when intrauterine pathology is suspected. To confirm the diagnosis a saline infusion sonography (SIS) and/or ambulant diagnostic hysteroscopy will be performed consequently. Once the diagnosis is confirmed and surgery is planned, women will be asked whether they want to take part in this study. At this moment, both techniques are used in our hospitals and the choice of treatment depends on the preference of the gynaecologist. All women will be treated with operative hysteroscopy in a daycare setting according to the standard of care, only now randomized between the two techniques. A standard postoperative visit with ultrasound examination and/or ambulant diagnostic hysteroscopy is scheduled 6 weeks later. Late postoperative complications and complaints are recorded.

It is expected that the HM beholds some advantages over the bipolar resectoscope such as shorter operating time and less complications (e.g. risk of perforation, current and fluid related complications). Previous data do not demonstrate any additional risks related to the use of the HM. Moreover we will check whether the HM has a lower risk of intrauterine adhesion formation, as this might influence patient's fertility.

After completion of the RCT, an observational study is planned considering pregnancies subsequent to the hysteroscopic procedure.


Options:
A: Arm Label: Additional diagnostic tests; Type: EXPERIMENTAL; Interventions: Procedure: Office hysteroscopy (in combination with a 'Saline Infusion Sonography'(SIS)) | Arm Label: Routine fertility workup; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: PROCEDURE; Name: Office hysteroscopy (in combination with a 'Saline Infusion Sonography'(SIS)); Assigned to Arm(s): Additional diagnostic tests
B: Arm Label: hysteroscopic morcellator; Type: EXPERIMENTAL; Interventions: Procedure: Hysteroscopic morcellator | Arm Label: Resectoscope; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Resectoscope | Intervention Type: PROCEDURE; Name: Hysteroscopic morcellator; Assigned to Arm(s): hysteroscopic morcellator | Intervention Type: PROCEDURE; Name: Resectoscope; Assigned to Arm(s): Resectoscope
C: Arm Label: dried biological amnion graft; Type: EXPERIMENTAL; Interventions: Procedure: dried biological amnion graft, Device: Foley balloon, Drug: estradiol valerate tablets+dydrogesterone Tablets | Arm Label: Foley catheter balloon only; Type: SHAM_COMPARATOR; Interventions: Device: Foley balloon, Drug: estradiol valerate tablets+dydrogesterone Tablets | Intervention Type: PROCEDURE; Name: dried biological amnion graft; Assigned to Arm(s): dried biological amnion graft | Intervention Type: DEVICE; Name: Foley balloon; Assigned to Arm(s): Foley catheter balloon only, dried biological amnion graft | Intervention Type: DRUG; Name: estradiol valerate tablets+dydrogesterone Tablets; Assigned to Arm(s): Foley catheter balloon only, dried biological amnion graft
D: Arm Label: Office hysteroscopy and endometrial snip; Type: EXPERIMENTAL; Interventions: Procedure: Office hysteroscopy and endometrial snip | Arm Label: Office hyteroscopy; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Office hysteroscopy | Intervention Type: PROCEDURE; Name: Office hysteroscopy and endometrial snip; Assigned to Arm(s): Office hysteroscopy and endometrial snip | Intervention Type: PROCEDURE; Name: Office hysteroscopy; Assigned to Arm(s): Office hyteroscopy

Answer: B