Sonographically guided hysteroscopic myomectomy (SGHM): minimizing the risks and maximizing efficiency

Hysteroscopic myomectomy (HM), first described by Neuwirth and Amin in 1976,1 is an important technique in the management of selected women presenting with infertility, abnormal uterine bleeding (AUB), or both. The complications of HM include excessive bleeding, uterine perforation, prolonged operative times, and excessive intravasation of distention media. The author describes his technique of sonographically guided hysteroscopic myomectomy (SGHM). SGHM allows one to continuously monitor the progress of resectoscopic surgery while minimizing the risk of uterine perforation and permitting one to incorporate non-resectoscopic morcellation. The combination of both resectoscopic and non-resectoscopic techniques enable one to safely and efficiently remove submucous leiomyomas without the risk of excessive fluid absorption.