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Case Reports
. 2020 Nov;46(11):2450-2453.
doi: 10.1111/jog.14481. Epub 2020 Sep 10.

Successful management of a submucosal fibroid using a hysteroscopic morcellator system in a patient with a history of total proctocolectomy: A case report

Kuniaki Ota  1 , Toshifumi Takahashi  1 , Norihito Kamo  2 , Yuta Endo  2 , Shigenori Furukawa  2 , Shu Soeda  2
Affiliations
Case Reports

Successful management of a submucosal fibroid using a hysteroscopic morcellator system in a patient with a history of total proctocolectomy: A case report

Kuniaki Ota et al. J Obstet Gynaecol Res. 2020 Nov.

Abstract

Transcervical resection is widely used in the management of submucosal fibroids. However, uterine perforation and thermal bowel injuries are known complications associated with the procedure. This is a case report of a 44-year-old woman who presented with heavy menstrual bleeding and anemia. Magnetic resonance imaging and hysteroscopy revealed multiple fibroids, including a submucosal type 1 fibroid. She had previously undergone a total proctocolectomy with intestinal pouch-anal anastomosis for ulcerative colitis. Because there was a high risk of permanent colostomy in the event of a bowel injury, an electrode-free, operative hysteroscopy using the Intrauterine Bigatti Shaver (IBS), a hysteroscopic morcellator system, was employed to prevent thermal bowel injury. The fibroid was completely removed using the IBS system with no complications. Therefore, we recommend the electrode-free use of a hysteroscopic morcellator system in patients with a history of extensive pelvic surgery.

Keywords: hysteroscopic surgery; leiomyoma; restorative proctocolectomy; ulcerative colitis.

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