Seven-year-experience in the hysteroresection of submucous myomas
Tiufekchieva, E.
Akusherstvo i Ginekologiia 46(4): 23-28
2007
ISSN/ISBN: 0324-0959 PMID: 17974191 Document Number: 610755
to summarize the results of hysteroscopic resections of submucous myomas, performed in the last 7 years in our clinic and to compare the results with those cited in the literature. 124 women at the age of (from) 24 to 66 years were operated, 63 of them (50.6%) were under 40 years and 42 women (33.9%) were nulliparous. The main complaints were abnormal uterine bleedings, pains and reproductive problems. 142 submucous myomas were resected. The mean diameter was 32.15 mm (from 5 to 55 mm); 8 myomas were 50 mm and more in diameter. The mean operational time was 33.4 min. The intraoperative complications were 3.2% (4 cases)--2 cases of bleeding and 2 cases of uterine perforation. Hospital stay--89 women (71.8%) were dehospitalized 24 hours after the operation and the other 32 women (28.2%)--8 hours after the operation. The postoperative follow-up included: 97 women--to 6 months, 83 women--to 1 year, 65 women--to 2 years and 31 women--to 3 years. The abnormal uterine bleedings disappeared in 100% of the cases which were followed up to 6 months. After 3 years 7 women, out of 31 observed, had abnormal bleeding; 5 women underwent hysterectomies because of intramural myomas, atypical endometrial hyperplasia, endometrial cancer, uterine prolapse. Eight of the women (47.0%) with reproductive problems became pregnant and 5 of them have already given birth (one of them--twice). The operative time, complications, postoperative hospital stay and the effect on the clinical symptoms were similar to those cited in the literature. The results of the study confirmed the advantages and the excellent potentialities of the hysteroscopy in the treatment of the submucous myomas. The method is extremely atraumatic, organ-preserving and highly effective in the elimination of the clinical symptoms. For this reason hysteroscopy should be the method of choice for treatment of the submucous myomas.