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Comparing Long-term Symptomatic Leiomyoma Recurrence Rates After Resection Using the Hysteroscopic Morcellator vs

Brooke M Fenske1, Priyal P Fadadu1, Malik Mays1

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Summary
This summary is machine-generated.

Comparing hysteroscopic mechanical tissue removal system (mTRS) and bipolar resection (BR) for fibroid removal showed no significant difference in long-term recurrence rates. Further research is needed to determine the optimal technique for treating uterine fibroids.

Keywords:
Bipolar ResectionHysteroscopic MorcellationUterine Leiomyoma

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Urogynecology

Background:

  • Uterine fibroids (leiomyomas) are common, causing symptoms like abnormal uterine bleeding.
  • Hysteroscopic myomectomy is a common treatment for symptomatic fibroids.
  • Comparing surgical techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare symptomatic leiomyoma recurrence rates after hysteroscopic myomectomy using the mechanical tissue removal system (mTRS) versus bipolar resection (BR).
  • To evaluate the long-term effectiveness of two hysteroscopic myomectomy techniques.

Main Methods:

  • Retrospective cohort study of premenopausal patients with International Federation of Gynecology and Obstetrics (FIGO) type 0-2 leiomyomas.
  • Comparison of hysteroscopic mechanical tissue removal system (mTRS) versus bipolar resection (BR) for fibroid resection.
  • Kaplan-Meier method used to estimate fibroid recurrence and hysterectomy risk over a mean follow-up of 7.1 years.

Main Results:

  • Symptomatic fibroid recurrence occurred in 29.2% of mTRS patients versus 38.5% of BR patients (p=NS).
  • Cumulative incidence of hysterectomy was similar: 15.7% for mTRS and 22.3% for BR.
  • Abnormal uterine bleeding was the most common indication for both index surgery and subsequent hysterectomy.

Conclusions:

  • No significant difference in long-term recurrence rates was observed between mTRS and BR for FIGO type 0-2 leiomyomas.
  • Larger prospective studies or randomized controlled trials are needed to definitively determine the most effective technique.
  • Both techniques appear comparable for managing symptomatic uterine fibroids, with recurrence often managed by repeat hysteroscopic procedures.