Successful strategy for the hysteroscopic myomectomy of a submucous myoma arising from the uterine fundus.

OBJECTIVE

To introduce a technique for hysteroscopic resection of submucous myoma arising from the uterine fundus.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 43-year-old nulliparous Japanese woman.

INTERVENTION(S): An original combination technique of hysteroresectoscopy using circumferential myoma scraping, central vaporization, and intraoperative injection of prostaglandin F2alpha.

MAIN OUTCOME MEASURE(S): Evaluation of clinical symptoms and imaging diagnosis.

RESULT(S): Resection of a 40-mm fundal myoma was performed hysteroscopically, and the menorrhagia of the patient was remedied by the operation.

CONCLUSION(S): Although large sessile fundal myomas are difficult to resect by hysteroscopic myomectomy, our original strategy may allow safe and certain surgery in such cases.