[Predictive factors for two-step hysteroscopic resection of submucosal fibroids. A single-center retrospective study]

Hysteroscopic resection of submucosal fibroids is an effective technique to reduce menometrorrhagia and improve fertility. Identifying predictors of two-step resections is essential to optimize preoperative counseling and surgical planning. The objective of this retrospective study was to assess predictive factors previously reported in the literature.

We analyzed 106 patients who underwent hysteroscopic fibroid resection at Lyon Sud University Hospital between January 2019 and January 2024.

Fibroid size was the only factor significantly associated with the need for a two-step resection. For fibroids ≥3cm in diameter, the odds ratio for requiring a second procedure was 13.3, with the risk increasing from 4.1% to 36.4%. Complication rates and fluid deficit were also higher in two-step resections.

Fibroid size appears to be the main predictor of two-step hysteroscopic resection. This finding has direct clinical relevance, as it allows for more accurate preoperative counseling of patients, more than one-third of whom may require a second intervention. Prospective multicenter studies are needed to confirm these results.