الفهرس | Only 14 pages are availabe for public view |
Abstract Uterine leiomyomata represent the most common genital tract neoplasm, with submucous myomas being the most clinically significant. They can cause abnormal uterine bleeding, pelvic pain and infertility. Hysteroscopic myomectomy remains the gold standard management of submucous leiomyomas. Different surgical techniques have been described for hysterscopic myomectomy, the most widely adopted of which so far being the classical resectoscopic slicing technique. Amongst the primary concerns following hysteroscopic myomectomy is the reproductive outcome in infertile women. Several other surgical techniques have been proposed aiming to maximize safety and improve outcomes; these include the use of bipolar electrosurgery replacing monopolar systems, Mazzon’s cold loop myomectomy technique, Lasmar’s and Litta’s techniques for enucleation of the myoma en toto, and the use of Nd Yag laser or fibroid vaporization. Little evidence is found in the literature as regards minimizing endometrial damage during hysteroscopic myomectomy. Such damage can manifest itself as thin or refractory endometrium on transvaginal ultrasonography, or as formation of intrauterine adhesions post operatively. This study was aimed to describe a new surgical technique primarily designed to preserve maximal endometrial tissue during hysteroscopic resection of submucous myomas, and to compare the efficacy of such technique to the classical resectoscopic slicing technique via assessment of the endometrium postoperatively by means of transvaginal ultrasonographic measurement of endometrial thickness as well as office hysteroscopic evaluation of the endometrial cavity and detection of IUAs. |