[Hysteroscopic myomectomy].

BACKGROUND

Hysteroscopic resection of submucous myomas is a safe alternative to conventional surgery.

AIM

To evaluate the anatomical and functional results of endoscopic resection of submucous myomas and to present the principle complications of this technique.

METHODS

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.

RESULTS

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.

CONCLUSION

Hysteroscopic resection of sub mucosal fibroids is a technique that respects the uterine cavity with satisfactory functional results and low morbidity.