Office hysteroscopic myomectomy without myoma extraction: A multicenter prospective study

Tanvir, Tanvir; Garzon, Simone; Pacheco, Luis Alonso; Yarto, Maite Lopez; Ríos, Mar; Stamenov, Georgi; Moratalla, Enrique; Shokeir, Tarek; Sedrati, Adel; Mikulasek, Lubomir; Laganà, Antonio Simone; Haimovich, Sergio

doi:10.1016/j.ejogrb.2020.11.048

Cited by 13 publications

(11 citation statements)

References 29 publications

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“…In our study, all the hysteroscopic myomectomy was performed using the traditional hysteroscopic resectoscope with myoma extraction and without using hysteroscopic morcellator. Some studies are debating the new techniques like office hysteroscopic myomectomy without myoma extraction and Hysteroscopic Tissue Removal systems (HTRs) [30,31]. These new techniques may impact the recurrence rate of submucosal myoma.…”

Section: Plos Onementioning

confidence: 99%

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy

et al. 2021

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Introduction Uterine leiomyoma (UL) is a common benign pelvic tumor in women that has a high recurrence rate. Our aim is to propose a prognostic index (PI) model for predicting the long-term recurrence risk of uterine leiomyoma (UL). Methods A total of 725 women who underwent myomectomy were enrolled in this retrospective multicenter study. Patients were contacted for follow-up. A PI model was proposed based on the multivariate Cox regression analysis in the model group. The predictive value of this model was tested in both internal and external validation group. Results PI formula = 1.5(if 3–5 leiomyomas) or 2(if >5 leiomyomas)+1(if residue)+1(if not submucosal)+1(if combined endometriosis). The PI value was divided into low-risk, intermediate-risk, and high-risk group by cut-off values 1.25 and 3.75. In the model group, the high-risk group had a significantly 4.55 times greater recurrence risk of UL than that in the low-risk group [cumulative recurrence rate (CR): 82.1% vs 29.5%, HR = 4.55, 95% CI 2.821–7.339]; the intermediate-risk group had a significantly 2.81 times greater recurrence risk of UL than that in the low-risk group (CR: 62.3% vs 29.5%, HR = 2.81, 95% CI 2.035–3.878). The differences between any two risk groups were also significant (P< 0.05) in both internal and external validation groups. Conclusion The model was proved to be effective in predicting recurrence of UL after myomectomy.

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Section: Plos Onementioning

confidence: 99%

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy

et al. 2021

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“…Finally, much space of our Topi-cal Collection was dedicated to minimally invasive surgery: of particular interest, we are glad to highlight the diagnosis and management of intramural ectopic pregnancy reported by Hu et al [10], whit good outcome as was reported for other type of ectopic pregnancies [11,12]. These points are of paramount importance, and allow us to remark the role of hysteroscopy [13,14] and laparoscopy [15] for the management of gynecological diseases.…”

mentioning

confidence: 91%

Topical Collection “Updates in obstetrics and gynecology”: summary of the first year

Laganà¹,

Garzon²

2021

Clin. Exp. Obstet. Gynecol.

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“…See-and-treat procedures are gaining popularity among all types of hysteroscopic procedures due to lower costs, higher availability, and faster return of patients to the daily routine, and RPOC removal is not an exception. [11][12][13][14][15] However, the see-and-treat approach in the office setting for the treatment of RPOC was shown to be a suitable alternative mainly for the ultrasound-guided intrauterine curettage. 16 Limited evidence is available concerning a comparison between the two hysteroscopic approaches.…”

Section: Introductionmentioning

confidence: 99%

“…This operative hysteroscopy allows patients to resume activities immediately, avoiding the added risks of anesthesia. See‐and‐treat procedures are gaining popularity among all types of hysteroscopic procedures due to lower costs, higher availability, and faster return of patients to the daily routine, and RPOC removal is not an exception 11–15 . However, the see‐and‐treat approach in the office setting for the treatment of RPOC was shown to be a suitable alternative mainly for the ultrasound‐guided intrauterine curettage 16 .…”

Section: Introductionmentioning

confidence: 99%

See‐and‐treat in‐office hysteroscopy versus operative hysteroscopy for the treatment of retained products of conception: A retrospective study

Raz

Sigal

Arjona

et al. 2022

J of Obstet and Gynaecol

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Aim To compare the efficacy and safety of in‐office hysteroscopy with a see‐and‐treat approach with that of operative hysteroscopy for the treatment of retained products of conception (RPOC). Methods We retrospectively identified all consecutive patients who underwent hysteroscopic treatment of RPOC between 2015 and 2019. We excluded patients with RPOC larger than 2 cm at preoperative transvaginal ultrasounds. Between 2015 and 2017, all hysteroscopic removals of RPOC were performed by operative hysteroscopy. Between 2018 and 2019, all cases of RPOC less than 2 cm in size were hysteroscopically removed by the see‐and‐treat approach in the office setting. Sociodemographic, clinical, and procedure characteristics along with complications were retrieved from medical records. Results Between 2015 and 2019, 119 women underwent hysteroscopic removal of RPOC equal to or smaller than 2 cm: 53 patients by in‐office hysteroscopy, and 66 by operative hysteroscopy. The two groups were similar in preoperative characteristics. Although the time required to complete the RPOC removal was similar, the total procedure and assistant time were significantly higher in the operative hysteroscopy group (p < 0.001). Moreover, operative hysteroscopy was associated with a higher proportion of cases complicated by excessive bleeding, cervical tear, or uterine perforation (p = 0.016). Failure to complete the procedure was similarly reported in the two groups (p = 0.58). Conclusions In‐office hysteroscopy with the see‐and‐treat approach for RPOC equal to or smaller than 2 cm appears as effective as operative hysteroscopy, but safer. In‐office hysteroscopy may be considered the first choice for treating RPOC equal to or smaller than 2 cm.

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Office hysteroscopic myomectomy without myoma extraction: A multicenter prospective study

Cited by 13 publications

References 29 publications

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy

A prognostic index model for predicting long-term recurrence of uterine leiomyoma after myomectomy

Topical Collection “Updates in obstetrics and gynecology”: summary of the first year

See‐and‐treat in‐office hysteroscopy versus operative hysteroscopy for the treatment of retained products of conception: A retrospective study

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