Single-step hysteroscopic myomectomy for submucous leiomyoma
- PMID: 32850190
- PMCID: PMC7406900
- DOI: 10.4274/tjod.galenos.2020.64280
Single-step hysteroscopic myomectomy for submucous leiomyoma
Abstract
Objective: Leiomyomas are most commonly observed benign tumors in the female genital tract. Depending on the size, number, and location, the complete resection of Type 0, 1, and 2 leiomyomas by hysteroscopy can be completed in a single-step or multi-step procedure. The purpose of this study is to document the cases of hysteroscopic myomectomy performed via the resectoscopic technique in the gynecology department of a university hospital. Moreover, we assessed the applicability of single- or multi-step hysteroscopic myomectomy with respect to the diameter of the leiomyoma.
Materials and methods: We retrospectively reviewed the records of hysteroscopic myomectomy performed between 2012 and 2018. According to the diameter of the submucous leiomyomas, we divided 46 patients into 2 groups. Group 1 (n=25) consisted of patients with submucous leiomyomas <3 cm, whereas patients in group 2 (n=21) had submucous leiomyomas ≥3 cm in diameter. We recorded the number of removed leiomyomas and completed hysteroscopy sessions.
Results: Myomectomy was completed by single-step hysteroscopy in all the patients of group 1, whereas eight patients in group 2 needed multiple sessions of hysteroscopy. None of the patients in group 1 had fluid overload; however, two patients in group 2 had mild asymptomatic hyponatremia.
Conclusion: The success of hysteroscopic myomectomy depends on the diameter, localization, and number of the leiomyomas. This study revealed that Type 0, 1, and 2 leiomyomas of less than 3 cm can be resected by single-step hysteroscopy. For larger leiomyomas, the possibility of need for further sessions should be shared with the patients.
Keywords: Hysteroscopy; leiomyoma; myomectomy.
©Copyright 2020 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House.
Conflict of interest statement
Conflict of Interest: The authors report no conflict of interest
References
-
- Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372:1646–55. - PubMed
-
- Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–7. - PubMed
-
- Munro MG, Critchley HO, Broder MS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113:1–2. - PubMed
-
- Capmas P, Levaillant JM, Fernandez H. Surgical techniques and outcome in the management of submucous fibroids. Curr Opin Obstet Gynecol. 2013;25:332–8. - PubMed
-
- Fernandez H, Sefrioui O, Virelizier C, Gervaise A, Gomel V, Frydman R. Hysteroscopic resection of submucosal fibroids in patients with infertility. Hum Reprod. 2001;16:1489–92. - PubMed
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