title: Hysteroscopic enucleation in toto of submucous type 2 myomas: long-term follow-up in women affected by menorrhagia.
abstract: OBJECTIVE
  To evaluate long-term efficacy of type 2 myoma enucleation in toto.
  
  
  METHODS
  Longitudinal retrospective study (Canadian Task Force classification II-2).
  
  
  METHODS
  University obstetrics and gynecology clinic.
  
  
  METHODS
  One hundred twelve women with menorrhagia and at least 1 type 2 submucous myoma who underwent hysteroscopic myoma enucleation in toto.
  
  
  METHODS
  Clinical long-term follow-up.
  
  
  RESULTS
  Success of the procedure and influence of myoma characteristics on recurrence of menorrhagia were evaluated. Mean (SD) follow-up was 58.4 (19.1) months. The success of the procedure was 88.4% (99 patients). Seventeen patients (15.2%) underwent a 2-step procedure. Among patients with relapsed menorrhagia, 10 (8.9%) underwent a repeat operation. Statistical analysis showed that number and diameter of myomas did not influence the outcome. Localization in the posterior wall of the uterus, compared with other sites, was associated with a higher percentage of resolution of menstrual symptoms (p = .03). There was no significant relationship between myomas features and risk of symptom recurrence during follow-up. The 2-step myomectomy was performed in patients with myomas >30 mm in diameter (p < .001).
  
  
  CONCLUSIONS
  Hysteroscopic enucleation in toto of type 2 myomas is a safe and effective technique in long-term management of premenopausal women with menorrhagia.
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy. Electronic address: carlo.saccardi@unipd.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Saccardi
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Conte
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Alberta
authors.initials: A
authors.lastname: Fabris
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Marchi
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Borghero
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gizzo
authors.affiliation: Department of Women's and Children's Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000601:surgery*; D008137:Longitudinal Studies; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D009214:Myoma / Q000601:surgery; D011247:Pregnancy; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000706:statistics & numerical data*; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Enucleation in toto; Hysteroscopy; Long-term outcome; Menorrhagia; Submucous type 2 myoma