Modified sonohysterography immediately after hysteroscopy in the diagnosis of submucous myoma

Abstract

Study objective: To report a new, convenient, inexpensive, office-based examination to evaluate submucous myomas before hysteroscopic myomectomy.

Design: Retrospective analysis (Canadian Task Force classification II-2).

Setting: University-affiliated teaching hospital.

Patients: One hundred seventy-nine consecutive women.

Intervention: Diagnostic flexible hysteroscopy and transvaginal ultrasonography.

Measurements and main results: Transvaginal ultrasonography was performed immediately after hysteroscopy. The size and depth of invasion of submucous myomas were clearly identified by retained fluid after hysteroscopy. Locations of myomas were as follows: anterior wall, 37 (20.7%); posterior wall, 52 (29.1%); lateral wall, 40 (22.3%); and fundus, 31 (17.3%); and multiple myomas, 19 (10.6%). Myomas with stalk were found in 101 patients (56.4%) and without stalk in 78 (43.6%). The mean myoma diameter was 2.95 +/- 2.12 cm and mean weight was 30.2 +/- 33.6 g.

Conclusion: It is important to obtain details as to size and depth of invasion of submucous myomas before hysteroscopic myomectomy. Sonohysterography immediately after hysteroscopy is superior to traditional diagnostic methods.