Transcervical hysteroscopic myomectomy: long-term effects on abnormal uterine bleeding.

OBJECTIVE

To evaluate the effectiveness of hysteroscopic myomectomy in the treatment of symptomatic submucous leiomyomas and long-term outcomes.

STUDY

DESIGN

A total of 107 patients with abnormal uterine bleeding (n = 84) and/or infertility (n = 23) were submitted to hysteroscopic resection.

MAIN OUTCOME MEASURES: control of menorrhagia and reproductive outcome.

RESULTS

Abnormal uterine bleeding was controlled in 68 out of 84 patients with one procedure; 15 needed a second procedure for incomplete resection. Five patients had menorrhagic pathology relapse. Among 23 patients with associated infertility pregnancy was achieved in eight cases, seven went to term and one miscarried; one patient needed a second procedure. The mean follow-up was 36 months (24-60). Three patients were lost at follow-up.

CONCLUSIONS

Transcervical hysteroscopic resection of submucous myomas is effective for control of abnormal uterine bleeding. Further studies are needed to define the value of such procedure in the treatment of infertility. Short and long-term results are strictly correlated to the possibility of obtaining a complete resection, which is conditioned by degree (0, 1, 2) and number of myomas.