Yendru Katyayani Swapna, Yelamanchi Savitha Devi, Vaddiraju Ganga Bhavani
Swapna Health Care, 6-3-1111/19, Nishathbagh, Begumpet, Hyderabad, Telangana 500 016 India.
J Obstet Gynaecol India. 2019 Apr;69(2):166-172. doi: 10.1007/s13224-018-1139-z. Epub 2018 May 31.
This study was conducted at Swapna Health Care (a tertiary centre for endoscopy), to analyse the outcome of hysteroscopic resection of submucous fibroids in 125 symptomatic women.
A total of 125 women were diagnosed with submucous fibroids between 1994 and 2017, 83 presented with AUB, 31 with infertility and four with RPL. Seven postmenopausal women had thickened endometrium on routine transvaginal ultrasonography, and hysteroscopy showed submucous fibroids.
Out of 83 with AUB, 68 were premenopausal and 15 were postmenopausal. All these patients underwent submucous fibroid resection by hysteroscopy. Out of 83, 75 (90.4%) had total relief from AUB and did not need any further management. Only eight patients needed hysterectomy after submucous fibroid resection. Thirty-one patients came for infertility. Twenty-five patients followed infertility treatment with us after SMFR. 32% of our infertile patients conceived (8/25).
Submucous fibroid resection is a safe procedure, giving good results in symptomatic women with AUB and infertility. Hence, all gynaecologists should be trained in diagnostic and operative hysteroscopy and should be able to offer this option to their patients in the spectrum of choices available.
本研究在Swapna医疗保健中心(一家三级内镜中心)进行,旨在分析125例有症状女性黏膜下肌瘤宫腔镜切除术的结果。
1994年至2017年间,共有125名女性被诊断为黏膜下肌瘤,其中83例表现为异常子宫出血(AUB),31例表现为不孕,4例表现为复发性流产(RPL)。7名绝经后女性经阴道超声检查发现子宫内膜增厚,宫腔镜检查显示为黏膜下肌瘤。
在83例AUB患者中,68例为绝经前患者,15例为绝经后患者。所有这些患者均接受了宫腔镜黏膜下肌瘤切除术。在83例患者中,75例(90.4%)AUB症状完全缓解,无需进一步治疗。只有8例患者在黏膜下肌瘤切除术后需要进行子宫切除术。31例患者因不孕前来就诊。25例患者在黏膜下肌瘤切除术后接受了我们的不孕治疗。我们的不孕患者中有32%(8/25)受孕。
黏膜下肌瘤切除术是一种安全的手术,对有AUB和不孕症状的女性效果良好。因此,所有妇科医生都应接受诊断性和手术性宫腔镜检查的培训,并应能够在可供选择的范围内为患者提供这种选择。