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J Minim Invasive Gynecol. 2018 Nov - Dec;25(7):1289-1294. doi: 10.1016/j.jmig.2018.05.002. Epub 2018 May 14.

Hysteroscopic Myomectomy of a Large Submucosal Leiomyoma with Novel Use of Fluid Warming.

Author information

1
Department of Obstetrics and Gynecology, Penn State Health, Hershey, Pennsylvania.
2
Department of Obstetrics and Gynecology, Penn State Health, Hershey, Pennsylvania. Electronic address: sestes@pennstatehealth.psu.edu.

Abstract

Uterine myoma size is often considered a limiting factor when choosing the surgical approach to myomectomy. In this case, a 35-year-old woman presented with heavy menstrual bleeding and desire for fertility. Ultrasound performed 3 months earlier could not assess the endometrium and suggested leiomyoma. Magnetic resonance imaging of the pelvis identified a fundal submucosal myoma measuring 6.8 × 7.1 × 3.5cm. A planned staged hysteroscopic resection of the large submucosal myoma with intramural component was achieved. Unassisted conception occurred 2 months later. She delivered by cesarean section at term without complications. This case demonstrates that hysteroscopic mechanical tissue removal device combined with ultrasound guidance and a fluid warming system can complete myomectomy for very large uterine myomas without the need for laparoscopy or laparotomy.

KEYWORDS:

Fertility; Hysteroscopy; Myoma; Myomectomy; Submucosal

PMID:
29772408
DOI:
10.1016/j.jmig.2018.05.002
[Indexed for MEDLINE]

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