title: Endoloop ligation technique for prolapsed pedunculated submucous uterine myoma: utility and reliability.
abstract: OBJECTIVE
  We use a non-surgical endoloop snare technique to remove prolapsed pedunculated submucous uterine myomas under the concept that ligating the pedicle causes tumor necrosis and natural elimination of the tumor. We evaluated our method on the basis of clinical outcomes.
  
  
  METHODS
  For pertinent clinical data, we reviewed the hospital records of 11 patients treated by our new method between July 2009 and 2010 and followed up for 22-31 months.
  
  
  RESULTS
  Patients' mean age was 40.9 years, and the mean hemoglobin level was 10.6 g/dl. None required urgent hospitalization, blood transfusion, or laparotomy. The tumors were eliminated naturally or removed by cutting necrotic pedicle within 4-11 days. One patient required a second endoloop application. Another one patient required follow-up surgery for a second submucous myoma, adenomyosis, and persistent hypermenorrhea.
  
  
  CONCLUSIONS
  Endoloop ligation is feasible for eliminating prolapsed pedunculated submucous myoma. It is simple and safe and can be performed in the outpatient setting.
authors.affiliation: Department of Obstetrics and Gynecology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-8521, Japan. tujihira@yahoo.co.jp
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ujihira
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagano
authors.forename: Daiki
authors.initials: D
authors.lastname: Ogishima
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008026:Ligation; D008875:Middle Aged; D009336:Necrosis; D011391:Prolapse; D012189:Retrospective Studies; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000295:instrumentation / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology*