Abnormal Uterine Bleeding and the MyoSure™ Tissue Removal System. A Retrospective Analysis of 14 Cases

Abstract

Study ObjectiveTo assess the effectiveness of a new hysteroscopic tissue removal system to remove intrauterine tissue and facilitate the diagnosis of endometrial carcinoma and premalignant abnormalities.DesignRetrospective analysis of 14 consecutive cases.SettingOutpatient surgical center.PatientsFourteen patients with abnormal uterine bleeding underwent hysteroscopic resection of intrauterine pathology. Mean patient age was 49.7 years (range 33 to 79 years); 64% were pre-menopusal and 36% were post-menopausal. All of the procedures were performed under general laryngeal mask anesthesia.InterventionPathology removal using the MyoSure™ Tissue Removal System (6.25 mm diameter hysteroscope and 3.0 mm diameter morcellator) and sterile saline for uterine distension.Measurements and Main ResultsHysteroscopic findings included seven polyps, three fibroids, and one gestational implantation site. The mean pathology size was 2.7 cm (range 1.9 to 5.8 cm). Pathological analysis of resected tissue revealed simple hyperplasia in three patients, and the presence of endometrial adenocarcinoma in one patient. There were no intraoperative complications. Patients were followed to an average of 8.3 months post procedure. There were no adverse events reported. There has been no pathology reoccurrence.ConclusionThe MyoSure™ Tissue Removal System resects intra-uterine tissue including fibroids, polyps, and endometrium under direct hysteroscopic visualization. By using mechanical energy, the cautery effect on tissue is avoided, and the tissue can be assessed clearly for pathological diagnosis. Abnormal uterine bleeding, both premenopausal and postmenopausal in nature, may be associated with malignant and premalignant conditions of the uterus. This case series demonstrates that MyoSure can safely and effectively remove these lesions and adequately enable pathological review of the specimen. Study ObjectiveTo assess the effectiveness of a new hysteroscopic tissue removal system to remove intrauterine tissue and facilitate the diagnosis of endometrial carcinoma and premalignant abnormalities. To assess the effectiveness of a new hysteroscopic tissue removal system to remove intrauterine tissue and facilitate the diagnosis of endometrial carcinoma and premalignant abnormalities. DesignRetrospective analysis of 14 consecutive cases. Retrospective analysis of 14 consecutive cases. SettingOutpatient surgical center. Outpatient surgical center. PatientsFourteen patients with abnormal uterine bleeding underwent hysteroscopic resection of intrauterine pathology. Mean patient age was 49.7 years (range 33 to 79 years); 64% were pre-menopusal and 36% were post-menopausal. All of the procedures were performed under general laryngeal mask anesthesia. Fourteen patients with abnormal uterine bleeding underwent hysteroscopic resection of intrauterine pathology. Mean patient age was 49.7 years (range 33 to 79 years); 64% were pre-menopusal and 36% were post-menopausal. All of the procedures were performed under general laryngeal mask anesthesia. InterventionPathology removal using the MyoSure™ Tissue Removal System (6.25 mm diameter hysteroscope and 3.0 mm diameter morcellator) and sterile saline for uterine distension. Pathology removal using the MyoSure™ Tissue Removal System (6.25 mm diameter hysteroscope and 3.0 mm diameter morcellator) and sterile saline for uterine distension. Measurements and Main ResultsHysteroscopic findings included seven polyps, three fibroids, and one gestational implantation site. The mean pathology size was 2.7 cm (range 1.9 to 5.8 cm). Pathological analysis of resected tissue revealed simple hyperplasia in three patients, and the presence of endometrial adenocarcinoma in one patient. There were no intraoperative complications. Patients were followed to an average of 8.3 months post procedure. There were no adverse events reported. There has been no pathology reoccurrence. Hysteroscopic findings included seven polyps, three fibroids, and one gestational implantation site. The mean pathology size was 2.7 cm (range 1.9 to 5.8 cm). Pathological analysis of resected tissue revealed simple hyperplasia in three patients, and the presence of endometrial adenocarcinoma in one patient. There were no intraoperative complications. Patients were followed to an average of 8.3 months post procedure. There were no adverse events reported. There has been no pathology reoccurrence. ConclusionThe MyoSure™ Tissue Removal System resects intra-uterine tissue including fibroids, polyps, and endometrium under direct hysteroscopic visualization. By using mechanical energy, the cautery effect on tissue is avoided, and the tissue can be assessed clearly for pathological diagnosis. Abnormal uterine bleeding, both premenopausal and postmenopausal in nature, may be associated with malignant and premalignant conditions of the uterus. This case series demonstrates that MyoSure can safely and effectively remove these lesions and adequately enable pathological review of the specimen. The MyoSure™ Tissue Removal System resects intra-uterine tissue including fibroids, polyps, and endometrium under direct hysteroscopic visualization. By using mechanical energy, the cautery effect on tissue is avoided, and the tissue can be assessed clearly for pathological diagnosis. Abnormal uterine bleeding, both premenopausal and postmenopausal in nature, may be associated with malignant and premalignant conditions of the uterus. This case series demonstrates that MyoSure can safely and effectively remove these lesions and adequately enable pathological review of the specimen.