Hysteroscopic myomectomy.
OBJECTIVE
To review the results of hysteroscopic myomectomy in 75 women with menorrhagia.


METHODS
A retrospective analysis of 75 women who were evaluated and treated between November 1, 1988, and March 3, 1994.


METHODS
Private gynecologic practice.


METHODS
Seventy-five women with menorrhagia with confirmed hysteroscopic evidence of one or more submucous myomata.


METHODS
Sixty-five women who had completed their childbearing underwent myomectomy and a concomitant procedure to destroy the endometrium. The remaining 10, who wished to retain their childbearing ability, underwent myomectomy alone. With two new techniques, large submucous myomata were removed rapidly and efficiently. Both laparoscopy and intraoperative ultrasound were performed when surgical guidance and control were thought to be necessary.


RESULTS
Myomectomy was performed in 55 (73%) of women without intraoperative control, and in 10 (13.4%) with laparoscopic and ultrasound control. No serious complications occurred. Three patients had leiomyomas of uncertain malignant potential, the significance of which underscores the importance of having all the tissue that is excised evaluated histologically. The outcome of a single operation was satisfactory to 84% of women.


CONCLUSIONS
Hysteroscopic myomectomy to control menorrhagia appears to be a safe and effective procedure. Two new techniques should improve its efficiency. In addition, controlling with ultrasound may help to avoid perforation injuries and obviate the need for laparoscopic guidance.
Wortman
M
M
Department of Obstetrics and Gynecology, University of Rochester School of Medicine, Rochester, New York, USA.
Dagget
A
A
D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000379:methods*; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008595:Menorrhagia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*