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Published on: September 12, 2025
Direct injection of vasopressin during hysteroscopic myomectomy: a case report
M Brigid Holloran-Schwartz1, Kallie Harrison, Richard Gimpelson
1Department of Obstetrics, Gynecology and Women's Health, St. Louis University, Missouri, USA. holloran@slu.edu
Background:
Hysteroscopic myomectomy is the ideal procedure for symptomatic women with submucosalfibroids who desire to preserve their fertility. Vascular myomas can limit visualization when a mechanical morcellator is used. Injection of a dilute vasopressin solution has been shown to decrease blood loss during laparoscopic myomectomy. To date, direct injection of a dilute vasopressin during hysteroscopic myomectomy has not been described.
Case:
Our first patient's hysteroscopic myomectomy of a vascular submucosal myoma had to be terminated before complete resection due to impaired visualization and maximum fluid overload. During a subsequent patient's procedure, direct injection ofa dilute vasopressin through the operative port decreased intraoperaftve bleeding and enabled complete resection.
Conclusion:
Injecting a dilute vasopressin solution directly into a vascular submucosal myoma during hysteroscopic resection can assist with hemostasis and visualization, enabling complete resection.
