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Updated: Aug 23, 2026
Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
Conservative treatment of diffuse uterine leiomyomatosis
Luigi Fedele1, Stefano Bianchi, Giovanni Zanconato
1Clinica Ostetrico-Ginecologica dell'Università di Milano, Ospedale San Paolo, Via Di Rudini no. 8, 20142 Milan, Italy. luigi.fedele@unimi.it
Objective:
To describe the conservative treatment of diffuse uterine leiomyomatosis.
Design:
Descriptive study.
Setting:
Tertiary care centers.
Patient(S):
Three premenopausal women with diffuse uterine leiomyomatosis associated to persistent menorrhagia, two with desire of becoming pregnant and one with desire of preservation of the uterus.
Intervention(S):
Preoperative ultrasound showed symmetrically enlarged uteri with innumerable, poorly defined and small-sized (0.5-3 cm) myomas involving all the myometrium. An "extreme" myomectomy was performed in two cases, including the removal of a large portion of corporal myometrium. One patient was treated only medically with GnRH analogues (GnRH-a).
Main Outcome Measure(S):
Menstrual pattern and, when applicable, ability to conceive and pregnancy outcome.
Result(S):
Regular menses were restored in both patients who underwent surgery: one had no pregnancy desire and the other was not able to conceive after two IVF-ETs. The patient treated with GnRH-a conceived spontaneously as soon as medical treatment was discontinued; at 34 gestational weeks, an emergency cesarean section followed by hysterectomy was performed for vaginal bleeding and a healthy 2,400-g baby was born.
Conclusion(S):
Our experience supports the idea that a conservative approach to uterine leiomyomatosis may result in restoration of normal cycles and eventually in the birth of a viable fetus.