Hysteroscopic myomectomy in postmenopausal women.

STUDY

OBJECTIVE

To review the findings in postmenopausal patients undergoing hysteroscopic myomectomy.

DESIGN

Retrospective case-controlled study (Canadian Task Force classification II-2).

SETTING

Private practice.

PATIENTS: Eighteen women with postmenopausal bleeding and two asymptomatic women with abnormal ultrasounds.

INTERVENTIONS: Hysteroscopic myomectomy in 19 patients, with concomitant destruction of the endometrium in 4 patients, and resectoscopic biopsy in 1 patient.

MEASUREMENTS AND MAIN

RESULTS

Three patients underwent subsequent gynecologic surgery. One had hysteroscopy to evaluate and remove an asymptomatic residual myoma found on ultrasound. A sarcoma was found in two of the symptomatic patients. Two patients underwent hysterectomy-one for a sarcoma and the other for a carcinoma of the cervix. One patient has had further postmenopausal bleeding.

CONCLUSION

Women who have a submucosal myoma that becomes symptomatic in the menopausal period may be at increased risk for a sarcoma.