Hysteroscopic morcellator used in the diagnosis and evacuation of retained products of conception

Background: Retained products of conception (RPOC) cause patients to have many symptoms that are often confusing to diagnose and treat. Surgical intervention with dilation and curettage, or hysteroscopic resection utilizing a resectoscope, is commonly performed. Case: A 32-year-old gravida 3, para 3, presented at Penn State Milton S. Hershey Medical Center, Hershey, PA, after a failed hysteroscopic removal of an intrauterine mass at a prior institution. The patient had persistent vaginal bleeding, pelvic discomfort, and dyspareunia after an uncomplicated cesarean delivery. Results: Successful removal of the large endometrial mass was accomplished with a hysteroscopic morcellator under ultrasound guidance. Pathology revealed necrotic placental tissue and chronic endometritis. As of this writing, the patient is doing well with normal menstrual cycles. Conclusions: This is the first case to describe a hysteroscopic morcellator used to assist with the removal of retained products of conception. Hysteroscopic morcellation is a safe and effective method used to completely remove retained products of conception. (J GYNECOL SURG 29:332)