title: Cold loops applied to bipolar resectoscope: A safe "one-step" myomectomy for treatment of submucosal myomas with intramural development.
abstract: OBJECTIVE
  To assess the safety and efficacy of cold loop myomectomy applied to bipolar resectoscope to perform "one-step" myomectomy of submucosal myomas with intramural involvement.
  
  
  METHODS
  Seventy-two patients with at least one symptomatic G1 or G2 myoma (Wamsteker's classification) underwent cold loop myomectomy from January 2011 to January 2013. All surgical procedures were performed using a 26Fr resectoscope and bipolar energy source. At one month after the procedure, all patients underwent an office hysteroscopy check-up. A subgroup of seven infertile patients underwent an office hysteroscopy every two-weeks to evaluate recovery time of the myometrial fovea.
  
  
  RESULTS
  Resectoscopic myomectomies were successfully performed in one surgical step in 70 out of 72 patients without any significant complications. Overall, the mean diameter of resected myomas was 32.2 ± 9 mm. Median operative time was 34.2 ± 24.1 min. Median fluid deficit was 761.22 ± 480.34 ml. The fovea was almost completely restored (>80%) six weeks after surgery in six of the seven infertile patients who underwent repeated follow-up office hysteroscopies every two weeks.
  
  
  CONCLUSIONS
  Data from the present study show that the use of cold loops applied to bipolar resectoscope represent an effective, safe technique for "one-step" myomectomy of G1-G2 myomas, allowing rapid recovery of the myometrial fovea.
authors.affiliation: Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Spiezio Sardo
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Palermo "P.Giaccone", Palermo, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Calagna
authors.affiliation: Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.affiliation: Department of Gynecology and Obstetrics, University of Salerno, Salerno, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Palermo "P.Giaccone", Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Perino
authors.affiliation: Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: bipolar resectoscope; cold loop; hysteroscopic myomectomy; hysteroscopy; submucosal myomas