Long-term results of hysteroscopic myomectomy in 235 patients.
OBJECTIVE
To assess the efficacy of transcervical resection of submucous fibroids according to type and size.


METHODS
Retrospective follow-up of 235 women with submucous fibroids at outpatient hysteroscopy who underwent a hysteroscopic transcervical resection. The main indications were the abnormal uterine bleeding and fertility problems. Thirty-seven percent of patients had an associated endometrial ablation and 32% had a polyp resection. Fifty-one percent of women were menopausal. In cases of incomplete resection a repeat procedure was offered.


RESULTS
Intra-operative complications were rare (2.6%) and there was no major complication. Eighty-four percent of cases were followed-up. The median follow-up was 40 months (range 18-66 months). The procedure was classed as a success in 94.4% of patients. Among the cases that were classed as a failure, four patients had a repeated hysteroscopic procedure, three patients had a subsequent hysterectomy and four patients presented with abnormal uterine bleeding at follow-up.


CONCLUSIONS
The hysteroscopic transcervical resection of submucous fibroids is a safe and highly effective long-term therapy for carefully selected women presenting with abnormal uterine bleeding and fertility problems. It produces satisfactory long-term results with few complications.
Polena
Viola
V
Service de gynécologie-obstétrique, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
Mergui
Jean-Luc
JL
Perrot
Nicolas
N
Poncelet
Christophe
C
Barranger
Emmanuel
E
Uzan
Serge
S
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D053208:Kaplan-Meier Estimate; D007889:Leiomyoma / Q000601:surgery*; D008796:Metrorrhagia / Q000601:surgery*; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013995:Time; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*