Hysteroscopic resection of type 3 myoma: a new challenge?

Eur J Obstet Gynecol Reprod Biol. 2016 Oct:205:165-9. doi: 10.1016/j.ejogrb.2016.06.026. Epub 2016 Aug 31.

Abstract

Objective: Type 3 myomas are intramural within contact with the endometrium but lack any cavity deformation. There is no guideline for management of symptomatic type 3 myoma. The aim of this study was to evaluate the feasibility of symptomatic type 3 myoma hysteroscopic resection.

Method: This retrospective study included symptomatic women (mainly pain, infertility or bleeding) who obtained an operative hysteroscopy for type 3 symptomatic myoma from June 2010 to December 2014 in the gynaecological unit of a teaching hospital.

Result: Thirteen women with an operative resection using bipolar electrosurgery of type 3 myoma during the study period (June 2010 to December 2014) were included in the study. Two women had a hysterectomy 6 and 12 months after the procedure and one woman had an open myomectomy 30 months after the procedure for the recurrence of abnormal bleeding. Postoperative office hysteroscopy show a postoperative synechiae in 3 women out of 8. Incomplete resection was also obtained in 3 women out of 8.

Conclusion: Hysteroscopic resection is a potential alternative to traditional surgery for type 3 myoma. This procedure must be confined to skilled surgeons because it is a difficult procedure. A postoperative office hysteroscopy is recommended in women of reproductive age.

Keywords: Fertility; Hysteroscopic resection; Type 3 myoma.

MeSH terms

  • Adult
  • Endometrium / surgery*
  • Female
  • Humans
  • Hysteroscopy / methods*
  • Infertility, Female / etiology
  • Infertility, Female / surgery
  • Leiomyoma / complications
  • Leiomyoma / surgery*
  • Menorrhagia / etiology
  • Menorrhagia / surgery
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / surgery*