Hysteroscopic Myomectomy

Abstract

Uterine myomas are benign encapsulated tumors that originate from the muscle tissue of the uterus. Submucosal myomas are associated with symptoms of abnormal uterine bleeding, dysmenorrhea, and reproductive problems. Hysteroscopic resection is currently the gold standard for symptomatic submucosal myoma treatment. The goal of hysteroscopic myomectomy is removal of the entire fibroid without compromising the surrounding myometrium or endometrium. Presurgical evaluation includes transvaginal ultrasound scanning (TVS), sonohysterography (SHG), and office hysteroscopy. Hysteroscopic resection of leiomyoma can be carried out by electrosurgical as well as mechanical instruments. Evolution of endoscopy made these myomas approachable and respectable through the inside of the uterus leading to avoidance of laparotomy and conventional or robotic myomectomy. Saline instillation sonography, which includes filling the endometrial cavity with fluid and then performing the ultrasound examination, also aids in distinguishing whether a myoma protrudes into the uterine cavity or not.