Procedural sedation for hysteroscopic myomectomy: costeffectiveness and patient preference (PROSECCO)

If fibroids are seen in the uterine cavity in women with heavy menstrual bleeding, hysteroscopic removal is the treatment of first choice. This procedure is often performed in the operating room under general anesthesia.
This study investigated whether outpatient myoma removal under procedural sedation and analgesia is just as (cost)effective as the same procedure in day care under general anesthesia in the operating room. For patients, this means a shorter hospital
stay. This study shows that fibroid removal under sedation has the benefits of shorter hospital visits and lower costs, while there is no difference in clinical outcome and quality of life. These results can be used by gynaecologists and anesthesiologists to better inform patients, preferably perform this procedure on an evidence-based basis in an outpatient setting under sedation, and to adjust guidelines for heavy menstrual bleeding.