Combined treatment for big submucosal myoma with High Intensity Focused Ultrasound and hysteroscopic resection
Wen-Liang Liao1, Tsung-Ho Ying1, Huang-Ping Shen2
1Department of Obstetrics and Gynecology, Chung Shan Medical University, Hospital, 1. No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 402, Taiwan, ROC; School of Medicine, Chung Shan Medical University, 1. No. 110, Sec. 1, Jianguo N. Rd., South Dist., Taichung City 402, Taiwan, ROC.
Objective:
Big submucosal myoma often causes heavy menstrual bleeding and are complicated in hysterscopic surgery. High Intensity Focused Ultrasound (HIFU), is a method for myoma ablation therapy, which may benefit on size reduction, and assist following hysterscopic myomectomy.
Case Report:
Two cases, case one,. 44-year-old female with 3.8 cm submucosal myoma, STEPW (Size, Topography, Extension, Penetration and Wall) score 6 and case 2. 48-year-old female, with 6.0 cm submucosal myoma, STEPW score 8, both received HIFU treatment before hysterscopic myomectomy was done. The myomas reduced after 5 months with improvement of anemia. The following hysterscopic myomectomy shows less operative time and fewer blood loss.
Conclusion:
HIFU reduce size of submucosal myoma and may improve anemia after months. Less operating time and blood loss were demonstrated in the following hysterscopic myomectomy. For well selected patients, combined treatment with HIFU and hysteroscopic resection may decrease complication rate.
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