Department of Obstetrics and Gynecology, Spaarne Ziekenhuis, Hoofddorp, the Netherlands.
Published: July 2009
AI Article Synopsis
Article Abstract
Objective: To determine whether surgical volume influences efficiency of hysteroscopic myomectomy as a treatment for uterine fibroids.
Study Design: This retrospective cross-sectional study performed at a university teaching hospital included all patients who underwent hysteroscopic myomectomy between 2001 and 2005 by a faculty surgeon. We used 3 outcomes as measures of efficiency: amount of tissue resected per case, operating department time per case and amount of tissue resected per minute.
Results: High-volume surgeons resected more tissue than low-volume surgeons (p = 0.01), had shorter operating department times (p = 0.018) and resected more tissue per time (p = 0.015).
Conclusion: High-volume surgeons have higher efficiency performing hysteroscopic myomectomy as a treatment for uterine fibroids.
Maternal and Child Department, Complex Operative Unit of Obstetrics and Gynecology, Hospital of Gubbio and Gualdo Tadino, ASL 1 Umbria, Perugia, PG, Italy.
This case report describes the dynamics of the detachment of the ceramic beak of an Iglesias resectoscope that was lost in the uterine cavity during 'cold loop' hysteroscopic myomectomy. Our aim is to increase awareness of this issue and caution our colleagues against using Iglesias resectoscopes for hysteroscopies. The ceramic beak of an Iglesias resectoscope can detach itself if hard tissue is encountered during operative hysteroscopy.
Submucosal uterine fibroids are the rarest type of fibroids. They can lead to abnormal uterine bleeding and may play a role in infertility and miscarriage. Hysteroscopic myomectomy is the preferred treatment to relieve bleeding caused by these fibroids and to restore the normal structure of the uterine cavity.
Hysteroscopic myomectomy is widely used to treat submucosal myomas. However, performing hysteroscopic surgery on certain type II (and even type III) or large myomas remains challenging. High-intensity focused ultrasound (HIFU) has recently emerged as a promising alternative for treating various gynecologic conditions.
Objective: To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the conventional hysteroscopic myomectomy (C-HM).
Study Design: The data from 94 patients aged 42 or younger who underwent HM (38 cases with UEP-HM and 56 cases with C-HM) for treating single Type 1 or Type 2 submucosal leiomyoma (SL) were analysed retrospectively for comparing the characteristics of both patient and target SL.
This study compared the outcomes of myomectomy performed with preoperative uterine artery embolization (UAE) versus myomectomy alone, focusing on blood loss and complications.
Results showed that blood loss was significantly lower in the UAE group, but there were similar rates for postoperative complications between the two groups.
Long-term fertility outcomes were concerning for the UAE group, with higher rates of adhesions, miscarriages, and obstetrical complications compared to the non-UAE group.
