A hybrid technique for the removal of a large prolapsed pedunculated submucous leiomyoma

Uterine leiomyomas are the most common benign pelvic tumor in females. Pedunculated submucous FIGO type 0 leiomyomas may eventually protrude through the cervical canal and prolapse into the vagina taking the name of "nascent" leiomyomas. Vaginal myomectomy is the main treatment for isolated prolapsed myoma and is successful in more than 95% of cases. We propose a hybrid technique that consists of a transvaginal myomectomy followed by an operative hysteroscopy with cervical torsion to complete the removal of the leiomyoma's pedicle. Our case demonstrates an uneventful removal of a large nascent leiomyoma using a hybrid technique for complete resection of the leiomyoma limiting the risk of recurrence.