[Value of surgical hysteroscopy in the treatment of myomas and intracavitary fibrous polyps. Evaluation of 26 operations].
Out of a total of 121 hysteroscopies carried out in this unit between December 1981 and June 1984, 26 were operative hysteroscopies. Each of these procedures consisted in removing intra-uterine structures (that could not be removed with a curette) under visual control. All cases had a normal sized or slightly enlarged uterus. There were 7 patients aged 41 years or younger and 19 older than 41. The endoscope used was the "bayonet" Wolf apparatus which is 7 mm in diameter and has two separate canals; one for insufflation and the other for introducing the 3 mm biopsy forceps. This small punch makes it possible to cut the implantation on uterine wall without needing coagulation. The tissue is then removed using a soft curette or a polyp forceps after the cervix has been further dilated. There was no case in which heavy bleeding occurred during or after the operation. Using this technique we were able to remove 18 fibroid polyps, 13 submucous fibroids (8 smaller than 2 cm in diameter and 5 between 2 and 4 cm), 3 old retained portions of placenta; removal was complete in 21 cases and only partial in 5 cases. Out of these 2 had to have hysterectomy. On the other hand abdominal myomectomy or hysterectomy could be avoided in 11 cases. This series shows how often fibrous polyps and small sub-mucous fibroids can be removed under hysteroscopic control when using this kind of apparatus and a relatively simple technique.
D000328:Adult; D004107:Dilatation and Curettage; D004724:Endoscopy; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011127:Polyps / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*
Intérêt de l'hystéroscopie opératoire dans le traitement des myomes et polypes fibreux intracavitaires. Bilan de 26 interventions.