One-step hysteroscopic removal of sinking submucous myoma in two infertilepatients

Citation
Bl. Lin et al., One-step hysteroscopic removal of sinking submucous myoma in two infertilepatients, FERT STERIL, 74(5), 2000, pp. 1035-1038
Citations number
4
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
FERTILITY AND STERILITY
ISSN journal
0015-0282 → ACNP
Volume
74
Issue
5
Year of publication
2000
Pages
1035 - 1038
Database
ISI
SICI code
0015-0282(200011)74:5<1035:OHROSS>2.0.ZU;2-L
Abstract
Objective: To report one-step resectoscopic removal of submucous myomas tha t were pushed back into the muscular layer by increased intrauterine pressu re during hysteroscopic procedures. Design: Case report. Setting: Kawasaki Municipal Hospital, Kawasaki, Japan. Patient(s): Two infertile women presenting with menorrhagia in whom submuco us myoma with a broad base was diagnosed. Intervention(s): One patient was pretreated with GnRH agonist for 4 months; the other patient did not receive this treatment. Resectoscopic myomectomi es were performed under close sonographic monitoring. Main Outcome Measure(s): Clinical symptoms and conception status. Result(s): Tumor sinking occurred during the hysteroscopic procedures, but complete resectoscopic removal of the submucous myomas was achieved under s onographic and hysteroscopic visualization. One patient experienced hyponat remia but recovered after conservative treatment. Both patients conceived a fter myoma removal. Conclusion(s): Sinking myomas, which may cause infertility, can be removed with a one-step hysteroscopic procedure. Sinking of submucous myomas during hysteroscopy might be caused by pretreatment with GnRH agonist and by incr eased intrauterine pressure during hysteroscopy. We recommend that intraute rine pressure be <45 mmHg, equivalent to hanging a bag of fluid under gravi ty control 70 cm above the patient's uterus, at the beginning of operations for sinking myomas. (Fertil Steril(R) 2000;74:1035-8. (C) 2000 by American Society for Reproductive Medicine.).