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Removing a large submucous fibroid hysteroscopically with the two-resectoscope method
1Department of Obstetrics and Gynecology, Kawasaki Municipal Hospital, 12-1, Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa-Ken, Japan.
Summary
Hysteroscopic myomectomy effectively treated large submucous fibroids causing heavy bleeding. This safe and efficient procedure improved symptoms in most patients, with some achieving successful pregnancies.
Area of Science:
- Gynecology
- Minimally Invasive Surgery
Background:
- Submucous fibroids often cause severe menorrhagia and anemia.
- Hysteroscopic myomectomy is a common treatment for these conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of hysteroscopic myomectomy for large submucous fibroids using two resectoscope sizes.
- To assess the impact on patient symptoms and reproductive outcomes.
Main Methods:
- 25 patients with large submucous fibroids underwent hysteroscopic myomectomy.
- A staged resection technique using 7-mm and 9-mm resectoscopes was employed.
- Cervical dilation with laminaria tents and simultaneous ultrasonography were utilized.
Main Results:
- Mean operative time was 49 minutes, with specimen weights averaging 78.5 g.
- 22 out of 25 patients experienced improvement in menorrhagia and anemia.
- One complication (cervical laceration) occurred; two patients had successful full-term deliveries after recurrence.
Conclusions:
- Hysteroscopic myomectomy is a safe and efficient treatment for large or sessile submucous fibroids.
- The technique effectively alleviates symptoms and can lead to positive reproductive outcomes.
- Further management may be needed for recurrent fibroids.