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• W2320370571 abstract "Objective: To establish indications for hysteroscopic versus transserosal myomectomy of submucous myomas located deep within the uterine wall.Design: Retrospective studySetting: Department of gynecology at a general hospital.Patients: Twenty-one women with submucous myomas, each with <50% of tumor diameter protruding into the uterine cavity. Twelve women underwent hysteroscopic myomectomy(group A),while transserosal myomectomy was performed for the other nine (group B).Intervention: Myomectomy,either hysteroscopic or transserosal In our hysteroscopic myomectomy, the endometrium is incised and opened along the equator of the myoma; it is then separated to enucleate the myoma completely. Thus the endometrium is conserved.Main Results: Mean maximum diameter of fibroid was 25.5 mm for group A and 40.0 mm for group B; the mean protrusion rate was 28.3 % for group A and 17.2 % for group B. The mean serosa-myoma thickness (SMT) was 15.3 mm for group A and 4.0mm for group B. In 7 cases, maximum diameter of the submucous fibroid was < 30mm, and the SMT was > 6 mm. These fibroids were completely removed by hysteroscopic myomectomy. In one case of submucous fibroids with maximum diameter of > 40mm and SMT of 7 mm, the fibroids were removed by 2 sessions of hysteroscopic myomectomy. In 9 cases of fibroids with maximum diameter of > 40mm or SMT < 5 mm, the tumors were easily removed by transmural myomectomy. In 4 cases with tumor diameters between 30mm and 40mm, the challenge level of transcervical resection varied depending on the SMT, the fibroid location, the presence of complications, and the possibility of obtaining sufficient preoperative dilatation of the cervical canal.Three patients conceived after hysteroscopic myomectomy and five patients conceived after transserosal myomectomy. Uterine rupture did not occur, and complication rates were low with both procedures.Conclusion: Transmural excision of submucous myomas may be optimal when maximum tumor diameter exceeds 40mm, whereas hysteroscopic myomectomy is better suited for submucous fibroids with maximum diameter under 30mm. With tumor diameters between 30mm and 40mm, either procedure may be utilized. In such cases, SMT and other factors will be useful determinants of an appropriate surgical approach." @default.
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• W2320370571 date "2011-01-01" @default.
• W2320370571 modified "2023-10-16" @default.
• W2320370571 title "Indications for Myomectomy of Deep Intramural Submucous Fibroids" @default.
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• W2320370571 doi "https://doi.org/10.5180/jsgoe.27.278" @default.
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