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Chapter-46 Hysteroscopic Myomectomy

BOOK TITLE: State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

Author
1. Magos Adam
2. Al-Shabibi Nawar
ISBN
9788184489903
DOI
10.5005/jp/books/11190_46
Edition
2/e
Publishing Year
2010
Pages
8
Author Affiliations
1. University Department of Obstetrics and Gynecology Royal Free Hospital, Pond Street Hampstead, London, Minimally Invasive Therapy Unit, and Endoscopy Training Centre, University Department of Obstetrics and Gynaecology, The Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, England, Royal Free Hospital, Pond Street, Hampstead, London, UK, Royal Free Hospital, Hampstead, London, UK
2. Royal Free Hospital Pond Street, Hampstead London
Chapter keywords

Abstract

Hysteroscopic myomectomy is a valuable technique for the treatment of menorrhagia and subfertility/recurrent pregnancy loss caused by submucous fibroids. Thirty years on from the initial description of the technique, the resectoscope remains the most efficient instrument for this type of surgery. Miniaturization of the resectoscope is a promising development which may extend the potential of this type of surgery to the office/outpatient setting. Fibroids are common benign tumors of the smooth muscle of the uterus. Ultrasonic evidence of fibroids is as high as 51% of premenopausal women has been reported with a cumulative incidence of >80% of black women compared to 70% of white women by age 50. The prevalence is higher in nulliparous women and in those of Afro-Caribbean origin. Submucous fibroids account for 5-10% of all leiomyoma, for which hysteroscopic resection remains the gold standard treatment. Surgery is associated with a high satisfaction rate of 70-85% of cases and is associated with a much lower morbidity than open procedure.

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