Hysteroscopic Myomectomy of a Large Submucosal Leiomyoma with Novel Use of Fluid Warming

Publication date: Available online 14 May 2018Source: Journal of Minimally Invasive GynecologyAuthor(s): Tess Chase, Stephanie J. EstesAbstractUterine myoma size is often considered a limiting factor when choosing the surgical approach to myomectomy. In this case, a 35-year-old woman presented with heavy menstrual bleeding and desire for fertility. Ultrasound performed 3 months earlier could not assess the endometrium and suggested leiomyoma. Magnetic resonance imaging of the pelvis identified a fundal submucosal myoma measuring 6.8 × 7.1 × 3.5cm. A planned staged hysteroscopic resection of the large submucosal myoma with intramural component was achieved. Unassisted conception occurred 2 months later. She delivered by cesarean section at term without complications. This case demonstrates that hysteroscopic mechanical tissue removal device combined with ultrasound guidance and a fluid warming system can complete myomectomy for very large uterine myomas without the need for laparoscopy or laparotomy.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research