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Fertil Steril. 2007 Dec;88(6):1667-73. Epub 2007 Jun 27.

Successful pregnancies in women with diffuse uterine leiomyomatosis after hysteroscopic management.

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1
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.

Abstract

OBJECTIVE:

To describe the surgical and reproductive outcomes of early diffuse uterine leiomyomatosis with hysteroscopic myomectomy.

DESIGN:

Retrospective report.

SETTING:

University hospital.

PATIENT(S):

Five consecutive women of reproductive age with innumerable small-sized (0.5-3 cm) diffuse uterine myomas with profuse menorrhagia.

INTERVENTION(S):

Use of hysteroscopic myomectomy to excise only myomas impinging into the endometrial cavity, while leaving other intramural myomas in place.

MAIN OUTCOME MEASURE(S):

Postoperative synechiae, recurrence, menstrual amount, conception, and pregnancy outcome.

RESULT(S):

A total of 10 hysteroscopic surgeries were performed, among which 1 patient had repeated adhesiolysis for postoperative synechiae, 2 experienced repeated myomectomy because of submucosal myoma recurrence, and 1 underwent a scheduled two-step procedure with gonadotropin-releasing hormone analogue treatment in between. The uterus was successfully preserved and a normal amount of menstruation was restored in all (5/5) patients. All (3/3) patients who wished to conceive had successful conceptions, with four healthy deliveries.

CONCLUSION(S):

Women with early-stage diffuse uterine leiomyomatosis can be treated by hysteroscopic resection, which has the benefits of preserving the uterus successfully, conceding a limited recurrence rate, and yielding satisfactory reproductive outcomes.

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