Safe techniques in surgery for hysteroscopic myomectomy.
Hysteroscopic myomectomy is regarded as the best treatment for patients with submucous myomata. However, this procedure has a number of associated complications, including uterine perforation, cervical laceration, hyponatremia and hemorrhage, especially in cases of sessile submucous myomata. To avoid these problems, it is important to make well-advised preparations and manipulations both pre- and intraoperatively. The main surgical considerations for safe hysteroscopic myomectomy are shortening the operating time and avoiding cutting too deeply into the myometrium. With these requirements in mind, a combination of techniques using vaporization and a powerful oxytocic agent, such as prostaglandin F-2alpha, appears to be the safest method of carrying out hysteroresectoscopy for unpedunculated sessile submucous myomata.
Murakami
Takashi
T
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan. tm@ob-gyn.tohoku.ac.jp
Tamura
Mitsutoshi
M
Ozawa
Yuka
Y
Suzuki
Haruka
H
Terada
Yukihiro
Y
Okamura
Kunihiro
K
D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D011183:Postoperative Complications; D014594:Uterine Neoplasms / Q000601:surgery*