Is Cold Loop Hysteroscopic Myomectomy a Safe and Effective Technique for the Treatment of Submucous Myomas With Intramural Development? A Series of 1434 Surgical Procedures

Abstract

Study objective: To assess the safety and efficacy of cold loop hysteroscopic myomectomy in a large series of cases.

Design: Retrospective study (Canadian Task Force Classification III).

Setting: Arbor Vitae Center for Endoscopic Gynecology, Rome, Italy.

Patients: A total of 1215 patients with 1 or more G1-G2 submucous myomas.

Intervention: Cold loop hysteroscopic myomectomy.

Measurement and main results: A total of 1690 myomas were removed. A minimum of 1 to a maximum of 5 fibroids for each surgical procedure were totally removed. Out of 1215 patients, 1017 (83.7%) were treated with a single surgical procedure. Twelve intraoperative complications occurred (0.84%). No cases of uterine perforation with the thermal loop or clinical intravasation syndrome were reported.

Conclusion: Cold loop hysteroscopic myomectomy seems to represent a safe and effective procedure for the removal of submucous myomas with intramural development, while at the same time respecting the anatomic and functional integrity of the myometrium. The use of a cold loop in resectoscopic myomectomy is associated with a low rate of minor intraoperative complications and an absence of major complications. This could be of primary relevance with a view to fertility and future pregnancies.

Keywords: Cold loop; Hysteroscopic myomectomy; Hysteroscopy; Intraoperative complications; Uterine myoma.