Myoma pseudocapsule: a distinct endocrino-anatomical entity in gynecological surgery.
BACKGROUND
The myoma pseudocapsule is a structure formed surrounding the uterine fibroid, that in the uterus separates the myoma from normal tissue; because literature is lack of detailed information concerning myoma pseudocapsule, the author reviewed this important topic.


METHODS
An extensive literature review from 1980 to 2008 was performed on the myoma pseudocapsule, using: fibroid, myoma, myomectomy and reproductive outcome, as keywords.


RESULTS
The fibroid removal should always be performed inside its pseudocapsule and with a careful stretching, to extract fibroid from the surrounding fibromuscular skeleton, breaking up the fibrous bridges; because the vascular network generally surrounds the myoma, detachment of the myoma occurring inside the pseudocapsule should cause less bleeding. The maintenance of myometrial integrity during myomectomy allows the facilitation of uterine healing and is of benefit for future reproductive outcome.


CONCLUSIONS
The benefits of intracapsular myomectomy are evident, because it preserves myometrial integrity and allows for restoration of the uterine musculature. This correct myomectomy, if done by laparoscopy, confers significant advantages in less intraoperative blood loss, short duration of hospital stay, few therapeutic antibiotic administration and better future fertility.
Tinelli
Andrea
A
Department of Obstetrics and Gynecology, Vito Fazzi Hospital, Piazza Muratore, Lecce 73100, Italy. andreatinelli@gmail.com
Malvasi
Antonio
A
Rahimi
Siavash
S
Negro
Roberto
R
Cavallotti
Carlo
C
Vergara
Daniele
D
Vittori
Giorgio
G
Mettler
Liselotte
L
D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D009214:Myoma / Q000473:pathology / Q000601:surgery*; D009215:Myometrium / Q000473:pathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*