Hysteroscopic management of large symptomatic submucous uterine myomas

Journal of Minimally Invasive Gynecology
M CamanniF Deltetto

Abstract

To evaluate the feasibility of hysteroscopic resection of large submucous uterine myomas. Prospective study (Canadian Task Force classification II-3). Surgery unit of minimally invasive gynecology. Thirty-three women with submucous myomas 5 cm or larger in diameter with menorrhagia, dysmenorrhea, or infertility. Hysteroscopic myomectomy. Satisfaction with the surgery and an improvement in symptoms were the primary outcomes. Possibility of 1-step resection; complication rate, and disease recurrence were also considered. Menorrhagia was the most frequent indication (91%). According to the Wamsteker classification, 84.8% were type II myomas, whereas 93.9% scored 5 or higher according to the classification of Lasmar and colleagues. Mean operating time was 50 minutes (interquartile range, 35-65). One-step excision was achieved in 81.8% of patients. Of 5 women with incomplete resection, 3 needed a second surgery, and 2 were symptom-free. Patients with myomas larger than 5 cm or with a Lasmar score higher than 7 were more likely to undergo a 2-step procedure. In patients with myomas larger than 6 cm, recovery time was significantly longer than in those with smaller myomas. We recorded 3 complications: intravasation, uterine perforatio...Continue Reading

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