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Chapter 12 - Hysteroscopic Resection of Submucosal Fibroids

Published online by Cambridge University Press:  10 October 2020

By
Rudi Campo ,
Cristine Di Cesare  and
S. Gordts
Edited by
Mostafa Metwally  and
Tin-Chiu Li
Mostafa Metwally
Affiliation:
University of Sheffield
Tin-Chiu Li
Affiliation:
The Chinese University of Hong Kong
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Summary

Fibroids represent an extremely common benign uterine pathology, being a major cause of abnormal uterine bleeding disorders. Although most myomas are of benign origin, it is important to have a correct diagnostic procedure prior to endoscopic myoma resection. Preoperative imaging techniques as well as histological criteria have to be taken into account. The true prevalence of uterine sarcoma in presumed fibroids is not known, given the wide range of prevalence (0.014–0.45%) from meta-analyses mainly based on retrospective trials. Age and certain imaging characteristics are associated with a higher risk of uterine sarcoma, although the risks remain low [1, 2].

Type
Chapter
Information
Modern Management of Uterine Fibroids , pp. 104 - 125
Publisher: Cambridge University Press
Print publication year: 2020

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References

Brölmann, H, Tanos, V, Grimbizis, G, et al. On behalf of the European Society of Gynaecological Endoscopy (ESGE) steering committee on fibroid morcellation. Options on fibroid morcellation: a literature review. Gynecol Surg 2015;12:3–15.Google Scholar
Paul, PG, Rengaraj, V, Das, T, et al. Uterine sarcomas in patients undergoing surgery for presumed leiomyomas: 10 years’ experience. J Minim Invasive Gynecol 2016 Mar–Apr;23(3):384–9.CrossRefGoogle Scholar
Dueholm, M, Lundorf, E, Sørensen, JS, et al. Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging. Hum Reprod 2002;17(1):195–200.CrossRefGoogle ScholarPubMed
Neuwirth, RS, Amin, HK. Excision of submucus fibroids with hysteroscopic control. Am J Obstet Gynecol 1976;126:95–99.Google Scholar
Munro, MG, Critchley, HO, Broder, MS, Fraser, IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in non-gravid women of reproductive age. Int J Gynaecol Obstet 2011;113:3–13.CrossRefGoogle Scholar
Wamsteker, K, Emanuel, MH, de Kruif, JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 1993;82:736–40.Google ScholarPubMed
Molinas, CR, Campo, R. Office hysteroscopy and adenomyosis. Best Pract Res Clin Obstet Gynaecol 2006;20:557–67.Google Scholar
Campo, R, Meier, R, Dhont, N, Mestdagh, G, Ombelet, W. Implementation of hysteroscopy in an infertility clinic: The one-stop uterine diagnosis and treatment. Facts Views Vis Obgyn 2014;6(4):235–9.Google Scholar
Campo, R, Van Belle, Y, Rombauts, L, et al. Office minihysteroscopy. Hum Reprod Update 1999;5(1) 73–81.CrossRefGoogle ScholarPubMed
Campo, R, Molinas, CR, Rombauts, L, et al. Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod 2005;20:258–63.CrossRefGoogle ScholarPubMed
El-Toukhy, T, Campo, R, Khalaf, Y, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet 2016;387(10038):2614–21.CrossRefGoogle ScholarPubMed
Li, J-J, Chung, JPW, Wang, S, Li, T-C, Duan, H. The investigation and management of adenomyosis in women who wish to improve or preserve fertility. Biomed Res International 2018;art ID 6832685:12 pages.CrossRefGoogle Scholar
Gordts, S, Grimbizis, G, Campo, R. Symptoms and classifications of uterine adenomyosis, including the place of hysteroscopy in diagnosis. Fertil Steril 2018;109:380–8.CrossRefGoogle ScholarPubMed
Rotenberg, L, Verhille, R, Schulz-Wendtland, R, et al. Multicenter clinical experience with large core soft tissue biopsy without vacuum assistance. Eur J Cancer Prev 2004 Dec;13(6):491–8.Google Scholar
Janssens, JP, Rotenberg, L, Sentis, M, Motmans, K, Schulz-Wendtland, R. Caution with microbiopsies of the breast: displaced cancer cells and ballistics. Eur J Cancer Prev 2006 Dec;15(6):471–3.Google Scholar
Emanuel, MH, Hart, A, Wamsteker, K, Lammes, F. An analysis of fluid loss during transcervical resection of submucous myomas. Fertil Steril 1997 Nov;68(5):881–6.CrossRefGoogle ScholarPubMed
Muzji, L, Boni, T, Bellati, F, et al. GnRH analogue treatment before hysteroscopic resection of submucous myomas: a prospective, randomized, multicenter study. Fertil Steril 2010 Sep;94(4):1496–9.Google Scholar
Zayed, M, Fouda, UM, Zayed, SM, Elsetohy, KA, Hashem, AT. Hysteroscopic myomectomy of large submucous myomas in a 1-step procedure using multiple slicing sessions technique. J Minim Invasive Gynecol 2015 Nov–Dec;22(7):1196–202.Google Scholar
Ferrero, S, Racca, A, Tafi, E, et al. Ulipristal acetate before high complexity hysteroscopic myomectomy: a retrospective comparative study. J Minim Invasive Gynecol 2016 Mar–Apr;23(3):390–5.CrossRefGoogle ScholarPubMed
Bigatti, G. The shaver technique for operative hysteroscopy. In: Tinelli, A, Alonso Pacheco, L, Haimovich, S, editors. Hysteroscopy. Cham: Springer; 2018: 635–648.CrossRefGoogle Scholar
Sancho, JM, Delgado, VS, Valero, MJ, et al. Hysteroscopic myomectomy outcomes after 3-month treatment with either Ulipristal Acetate or GnRH analogues: a retrospective comparative study. Eur J Obstet Gynecol Reprod Biol 2016 Mar;198:127–30.CrossRefGoogle ScholarPubMed
Rakotomahenina, H, Rajaonarison, J, Wong, L, Brun, JL. Myomectomy: technique and current indications. Minerva Ginecol 2017 Aug;69(4):357–69. doi: 10.23736/S0026-4784.17.04073-4. Epub 26 Apr 2017.Google ScholarPubMed
Mazzon, I, Bettocchi, S, Fascilla, F, et al. Resectoscopic myomectomy. Minerva Ginecol 2016 Jun;68(3):334–44.Google ScholarPubMed
Mazzon, I, Favilli, A, Grasso, M, et al. Predicting success of single step hysteroscopic myomectomy: a single centre large cohort study of single myomas Int J Surg 2015 Oct;22:10–14.CrossRefGoogle ScholarPubMed
AAGL. Practice report: practical guidelines for the management of hysteroscopic distension media. J Minim Invasive Gynecol 2013;20:137–48.Google Scholar
Istre, O. Managing bleeding, fluid absorption and uterine perforation at hysteroscopy. Best Pract Res Clin Obstet Gynaecol 2009;23(5):619–29.Google Scholar
Umranikar, S, Clark, TJ, Saridogan, E, et al. BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy. Gynecol Surg 2016;13(4):289–303.CrossRefGoogle ScholarPubMed
Litta, P, Leggieri, C, Conte, L, et al. Monopolar versus bipolar device: safety, feasibility, limits and perioperative complications in performing hysteroscopic myomectomy. Clin Exp Obstet Gynecol 2014;41(3):335–8.CrossRefGoogle ScholarPubMed
Mazzon, I, Favilli, A. Does cold loop hysteroscopic myomectomuy reduce intrauterine adhesions? a retrospective study. Fertil Steril 2014;101:294–8.Google Scholar
Di Spiezio Sardo, A, Calagna, G, Di Carlo, C, et al. Cold loops applied to bipolar resectoscope: a safe “one-step” myomectomy for treatment of submucosal myomas with intramural development. J Obstet Gynaecol Res 2015 Dec;41(12):1935–41.CrossRefGoogle ScholarPubMed
Mazzon, I, Favilli, A, Grasso, M, et al. Is cold loop hysteroscopic myomectomy a safe and effective technique for the treatment of submucous myomas with intramural development? a series of 1434 surgical procedures. J Minim Invasive Gynecol 2015 Jul–Aug;22(5):792–8.CrossRefGoogle ScholarPubMed
Korkmazer, E, Tekin, B, Solak, N. Ultrasound guidance during hysteroscopic myomectomy in G1 and G2 Submucous Myomas: for a safer one step surgery. Eur J Obstet Gynecol Reprod Biol 2016 Aug;203:108–11. doi: 10.1016/j.ejogrb.2016.03.043. Epub 17 May 2016.CrossRefGoogle ScholarPubMed
Wortman, M. Sonographically guided hysteroscopic myomectomy (SGHM): minimizing the risks and maximizing efficiency. Surg Technol Int 2013 Sep;23:181–9.Google ScholarPubMed
Ludwin, A, Ludwin, I, Pityński, K, et al. Transrectal ultrasound-guided hysteroscopic myomectomy of submucosal myomas with a varying degree of myometrial penetration. J Minim Invasive Gynecol 2013 Sep–Oct;20(5):672–85.CrossRefGoogle ScholarPubMed
Bigatti, G. BS® Integrated Bigatti Shaver, an alternative approach to operative hysteroscopy. Gynecol Surg 2011 May;8(2):187–91.CrossRefGoogle Scholar
Bigatti, G, Ferrario, C, Rosales, M, Baglioni, A, Bianchi, S. A 4-cm G2 cervical submucosal myoma removed with the IBS® Integrated Bigatti Shaver. Gynecol Surg 2012 Nov;9(4):453–6. Epub 3 Mar 2012.CrossRefGoogle ScholarPubMed
Bigatti, G, Franchetti, S, Rosales, M, Baglioni, A, Bianchi, S. Hysteroscopic myomectomy with the IBS® Integrated Bigatti Shaver versus conventional bipolar resectoscope: a retrospective comparative study. Gynecol Surg 2014 Feb; 11(1):9–18.CrossRefGoogle Scholar
Vitale, SG, Sapia, F, Rapisarda, AMC, et al. Hysteroscopic morcellation of submucous myomas: a systematic review. Biomed Res Int 2017;2017:6848250. Published online 29 Aug 2017.CrossRefGoogle ScholarPubMed
Cohen, S, Greenberg, JA. Hysteroscopic morcellation for treating intrauterine pathology. Rev Obstet Gynecol 2011 Summer;4(2):73–80.Google Scholar
Cicinelli, E, Mitsopoulos, V, Fascilla, FD, Sioutis, D, Bettocchi, S. The OPPIuM technique: office hysteroscopic technique for the preparation of partially intramural leiomyomas. Minerva Ginecol 2016 Jun;68(3):328–33.Google Scholar
Haimovich, S, Mancebo, G, Alameda, F, et al. Feasibility of a new two-step procedure for office hysteroscopic resection of submucous myomas: results of a pilot study. Eur J Obstet Gynecol Reprod Biol 2013 Jun;168(2):191–4.Google Scholar
Grove, JJ, Shinaman, RC, Drover, DR. Noncardiogenic pulmonary edema and venous air embolus as complications of operative hysteroscopy. J Clin Anesth 2004 Feb;16(1):48–50.Google Scholar
Van Kruchten, PM, Vermelis, JM, Herold, I, Van Zundert, AA. Hypotonic and isotonic fluid overload as a complication of hysteroscopic procedures: two case reports. Minerva Anestesiol 2010 May;76(5):373–7.Google ScholarPubMed
Wheeler, JM, Taskin, O. Second-look office hysteroscopy following resectoscopy: the frequency and management of intrauterine adhesions. Fertil Steril 1993;60:150–6.Google Scholar
Tanaka, M, Matsuzaki, S, Matsuzaki, S, et al. Placenta accreta following hysteroscopic myomectomy. Clin Case Rep 2016 Apr 20;4(6):541–4.CrossRefGoogle ScholarPubMed
Mathiesen, E, Hohenwalter, M, Basir, Z, Peterson, E. Placenta increta after hysteroscopic myomectomy. Obstet Gynecol 2013 Aug;122(2 Pt 2):478–81.Google Scholar

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