Hysteroscopic resection of submucosal myomas in patients with infertility

Fernandez, H.; Sefrioui, O; Virelizier, Christelle Faure; Gervaise, A.; Gomel, Victor; Frydman, René

doi:10.1093/humrep/16.7.1489

Cited by 143 publications

(73 citation statements)

References 18 publications

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“…The incidence of submucosal myomas in women during their reproductive age ranges from 20 to 25 % [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Most of submucosal myomas may induce severe clinical symptoms such as abnormal uterine bleeding and menorrhagia with an incidence ranging from 60 to 84 % [3], dysmenorrehea , and infertility [1,2,4,5]. The hysteroscopic treatment of this pathology has shown to be effective in relieving symptoms and in improving on the patients' fertility [6].…”

Section: Introductionmentioning

confidence: 99%

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Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

et al. 2014

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From June 2011 to June 2013, all hysteroscopic myoma resections at the Ospedale San Giuseppe of Milan were performed using either the IBS® or the Versapoint® bipolar resectoscope. Dilatation time of the cervical canal, resection time, fluid balance, and complete single-stage removal of the myoma have been studied. The outcome was stratified for groups of myomas larger and smaller than 3 cm. Seventy-six myomectomies were performed with the IBS® and 51 with the Versapoint®. Both groups had a similar distribution of difficult cases like G2 and larger than 3 cm myomas. The results show no difference in terms of cervical dilatation, resection time, and fluid deficit between the two groups, but, for myomas less than 3 cm and G2 myomas, the IBS® has been able to treat respectively 93.5 % (p=0.3753) and 62.5 % (p=0.5491) of cases in a single step procedure. The overall number of necessary second procedures has been statistically significantly less in the IBS® Group than in the Versapoint® Group (p=0.0067). Although no significative difference in terms of time of resection, the IBS® has proven to be able to approach all kind of submucosal myomas in a single-step procedure and in a very precise and easy way. The IBS® can be considered a valid alternative to the conventional resectoscope.

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“…The incidence of submucosal myomas in women during their reproductive age ranges from 20 to 25 % [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

et al. 2014

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“…13 Other studies also concluded that hysteroscopic leiomyoma resection also improves fertility rates, especially when tumors are the sole cause of infertility. [14][15][16] Even uterine artery embolization is an angiographic interventional procedure that delivers particulate emboli into both uterine arteries. Uterine blood flow is therefore obstructed, producing ischemia and necrosis.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic submucous uterine fibroid: outcome of conservative surgery in a tertiary care hospital

Gupta

2016

Int J Reprod Contracept Obstet Gynecol

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“…Adhesions around salpinges could result from subserosal myomas [15]. The distortion and enlargement of the endometrial cavity by submucous and intramural fibroids with an intracavitary component can affect the implantation [19,20]. Implantation is also affected by vascular disturbances and inflammation of the endometrium and secretion of vasoactive substances [16,21].…”

Section: Fibroids and Infertilitymentioning

confidence: 99%

Hysteroscopic morcellation

2008

Modern Management of Abnormal Uterine Bleeding

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Uterine leiomyoma is the most common benign tumour occurring in women in the reproductive age. It is typically found during the middle and later reproductive years. The prevalence quoted in literature ranges from 20-50% based on post mortem studies. The symptoms usually reported by women with fibroids are the following: abnormal gynaecologic haemorrhage, chronic pelvic pain, dyspareunia, as well as urinary and bowel symptoms, urinary frequency or retention and, in some cases, infertility. During pregnancy, premature labor might be caused, interfering with the position of the fetus or abortion could be induced. However, only 30% of the women develop symptoms, most of them being asymptomatic. It was proved that the factors that can cause fibroids are the following: genetic, hormonal, and growth factors, especially transforming the growth factor beta (TGFb)-related cellular changes. As diagnosis tools, studies are revealing that ultrasound has been shown to be an insufficient method of myoma mapping, and magnetic resonance imaging should be preferred for surgical therapy planning. The contour of the endometrial cavity is delineated by using trans vaginal ultrasound and saline infusion hysterosonography, but hysteroscopy is the gold standard to evaluate the uterine cavity.

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Hysteroscopic resection of submucosal myomas in patients with infertility

Abstract: Hysteroscopic myomectomy appears safe, and is effective in the control of menstrual disorders. However, the effect on infertility seems limited, particularly in terms of delivery rate. The advanced age of the patients may partly explain these results.

Cited by 143 publications

References 18 publications

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study

Symptomatic submucous uterine fibroid: outcome of conservative surgery in a tertiary care hospital

Hysteroscopic morcellation

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