[Hysteroscopic myomectomy].

Abstract

Hysteroscopic resection of submucous myomas is a safe alternative to conventional surgery.
To evaluate the anatomical and functional results of endoscopic resection of submucous myomas and to present the principle complications of this technique.
This is a retrospective study performed in the department "B" of gynecology and obstetrics in maternity center of Tunis "La Rabta". It analyzes a series of 105 hysteroscopic resections of intracavitary fibroids during a period of 8 years from January 2003 to December 2010.
The mean age of our patients was 41 years and 5 months. The most frequently reason for consultation was the disorder of the menstrual cycle type of menometrorrhagia (47.6%), menorrhagia (22.8%) and postmenopausal bleeding (11.4%). Preoperative assessment of the fibroid was based on transvaginal ultrasound in all cases associated with diagnostic hysteroscopy in 51.4% of cases and with hydrosonography in 28.6% cases. The mean size of the fibroid was 3.08 cm. Type 0 myomas represented 42.8% of cases. The most frequent emplacement of the myoma was the anterior surface of the uterus (44.7%). After surgery, the resection was considered as complete in 88 patients (83.8%), partial in 17 patients (16.2%) requiring a second operation. The functional result was good with disappearance of bleeding symptoms in 90% of cases after a mean follow up of 17 months.
Hysteroscopic resection of sub mucosal fibroids is a technique that respects the uterine cavity with satisfactory functional results and low morbidity.