Would a woman with vaginal bleeding due to uterine fibroids or polyps be a candidate for the Endocee procedure?

Endocee Procedure Candidacy for Vaginal Bleeding

I cannot identify what the "Endocee procedure" is based on the provided evidence or standard medical literature. No medical procedure by this name exists in current gynecologic practice guidelines or research.

Possible Interpretations

If you are referring to endometrial ablation or hysteroscopic procedures for abnormal uterine bleeding:

For Uterine Fibroids or Polyps Causing Bleeding

Hysteroscopic myomectomy is the procedure of choice for submucosal fibroids causing abnormal bleeding, though large fibroids (>5 cm) may require multiple procedures 1.

Treatment Algorithm Based on Pathology:

For Submucosal Fibroids:

• Hysteroscopic myomectomy provides effective symptom relief with minimal invasiveness for fibroids protruding into the uterine cavity 1
• Fibroids ≤5 cm are ideal candidates for single-stage hysteroscopic resection 1
• Larger submucosal fibroids may require staged procedures or alternative approaches 1

For Endometrial Polyps:

• Hysteroscopic polypectomy is the definitive treatment for symptomatic polyps causing bleeding 2
• Saline-enhanced vaginal sonohysterography clearly improves visualization of polyps and submucous myomas in 89% of cases (17 of 19 women) 2

For Intramural or Subserosal Fibroids:

• Uterine artery embolization (UAE) achieves 95% symptomatic relief at 12 months with median fibroid volume reductions of 42% 3
• UAE demonstrates menorrhagia improvement in 83% of patients 3
• Myomectomy or hysterectomy are surgical alternatives depending on fertility desires 4, 5

Critical Diagnostic Steps Before Any Procedure

In postmenopausal women with fibroids and abnormal bleeding, endometrial biopsy is essential to rule out endometrial cancer or sarcoma before proceeding with treatment 1.

• Transvaginal ultrasound is the preferred initial imaging modality 1, 5
• MRI with contrast provides detailed evaluation for treatment planning when needed 1, 5

Common Pitfall

Do not proceed with any uterine-preserving procedure without first excluding malignancy in postmenopausal women or those with suspicious bleeding patterns 1. Unexplained vaginal bleeding suspicious for serious conditions requires evaluation before initiating treatment 6.

Please clarify the exact procedure name you are asking about, as "Endocee" does not correspond to any recognized gynecologic intervention.