Transcervical resection of submucous myoma.

Thirteen women with chief complaints of menorrhagia and metrorrhagia underwent transcervical resection (TCR) of pedunculated submucous myoma using either an operating hysteroscope or urologic resectoscope. Eight women received TCR with a urologic resectoscope without further operation. Subsequent vaginal hysterectomy was performed on one woman after TCR of a large prolapsed submucous fibroid with a urologic resectoscope because of adenomyosis. Three women underwent TCR of the same type of large prolapsed submucous myoma with an operating hysteroscope. Later, due to other pathologic lesions of the uterus, subsequent vaginal hysterectomies were done on two women and a subsequent abdominal hysterectomy on another woman. Without TCR of these large prolapsed submucous myoma, subsequent vaginal hysterectomies were not possible. Only one woman underwent TCR of submucous myoma with an operating hysteroscope without further operation. All patients showed improvement in such clinical symptoms as menorrhagia, metrorrhagia, and anemia. Before TCR, we make it a rule to use a new diagnostic hysteroscope (4mm external sheath) to reevaluate the position and size of the fibroid. The fluid media used were 10% dextrose for diagnostic hysteroscopy, 5% dextrose for therapeutic hysteroscopy and 10% urigal for urologic resectoscopy. Three months after the operation, second look hysteroscopy is arranged. All patients except one have been followed up at our outpatient department.