title: Role of a bipolar resectoscope in subfertile women with submucous myomas and menstrual disorders.
abstract: OBJECTIVE
  To evaluate the role of the Gynecare (Ethicon, Somerville, NJ, USA) bipolar resectoscope in resecting fibroids, and the effect of hysteroscopic myomectomy on infertility and pregnancy outcomes.
  
  
  METHODS
  From January 2000 to December 2005, we studied 59 women of reproductive age with menorrhagia, submucous myomas and one or more infertility factors. All women who participated had been subfertile for over 2 years. Fifteen of the 59 women displayed submucous myoma type O (intracavitary), 34 displayed submucous myoma type I (less than 50% within the myometrium) and the remaining 10 women displayed myoma type II (over 50% being within the myometrium). The mean age and standard deviation of these patients was 34.6 +/- 4.4 years and the average size of myomas was 15 +/- 10 mm. Treatment of these myomas was by hysteroscopic resection using a bipolar resectoscope.
  
  
  RESULTS
  Menorrhagic incidents improved in 20 of 32 women (62.5%). Twenty-five women (42.4%) succeeded in becoming pregnant. The pregnancy rate was notably higher when the sole reason of subfertility was the presence of myoma (54.16%), and when the size of the myoma was equal to 2.5 cm (75%) or more.
  
  
  CONCLUSIONS
  The use of the bipolar resectoscope in hysteroscopic removal of small submucous myomas is shown to be both feasible and effective in controlling menorrhagia and increasing the pregnancy rate in subfertile women, when submucous myomas are the only reason of infertility.
authors.affiliation: Hysteroscopic Unit, First Department of Obstetrics and Gynecology, University of Athens, Alexandra Maternity Hospital, Athens, Greece. nmakris@med.uoa.gr
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Makris
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Vomvolaki
authors.forename: George
authors.initials: G
authors.lastname: Mantzaris
authors.forename: Kostas
authors.initials: K
authors.lastname: Kalmantis
authors.forename: John
authors.initials: J
authors.lastname: Hatzipappas
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020702:Hysteroscopes; D015907:Hysteroscopy / Q000379:methods*; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D007889:Leiomyoma / Q000150:complications / Q000601:surgery*; D008595:Menorrhagia / Q000150:complications / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery*