Hysteroscopic Myomectomy for Type 2&3 Myomas

Abstract

Study Objective To determine the optimal management of type 2 and type 3 myomas affecting menstrual blood loss and infertility Design case series, 2 year follow up. Setting hysteroscopy under general anaesthesia in the dorsal lithotomy position. Patients or Participants 86 infertility or recurrent pregnancy loss patients diagnosed with a type 2 or type 3 myoma ( Interventions Hysteroscopic myomectomy with techniques for accessing deeply intramural myomas by resectoscopy and cold techniques shown videographically to avoid laparoscopic and open techniques which require a more invasive surgery and myometrial incision. Prevention of hysteroscopic complications such as volume overload, perforation and bleeding through precise surgical technique and set-up. Measurements and Main Results Complete resection of the myoma is the primary outcome. 78/86 patients had a successful myomectomy in 1 setting, 8/86 patients required a second setting. Secondary outcome is pregnancy where 75.5% pregnancy rate was achieved within one year of the procedure. Conclusion Hysteroscopic myomectomy is a valuable approach in cases of type 2 and type 3 myomas