Fertility and sterility · 2007
Successful pregnancies in women with diffuse uterine leiomyomatosis after hysteroscopic management.
Клинический случайОценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Yen Chih-Feng, Lee Chyi-Long, Wang Chin-Jung, Soong Yung-Kuei, Arici Aydin
Аннотация
OBJECTIVE: To describe the surgical and reproductive outcomes of early diffuse uterine leiomyomatosis with hysteroscopic myomectomy.
DESIGN: Retrospective report.
SETTING: University hospital.
PATIENT(S): Five consecutive women of reproductive age with innumerable small-sized (0.5-3 cm) diffuse uterine myomas with profuse menorrhagia.
INTERVENTION(S): Use of hysteroscopic myomectomy to excise only myomas impinging into the endometrial cavity, while leaving other intramural myomas in place.
MAIN OUTCOME MEASURE(S): Postoperative synechiae, recurrence, menstrual amount, conception, and pregnancy outcome.
RESULT(S): A total of 10 hysteroscopic surgeries were performed, among which 1 patient had repeated adhesiolysis for postoperative synechiae, 2 experienced repeated myomectomy because of submucosal myoma recurrence, and 1 underwent a scheduled two-step procedure with gonadotropin-releasing hormone analogue treatment in between. The uterus was successfully preserved and a normal amount of menstruation was restored in all (5/5) patients. All (3/3) patients who wished to conceive had successful conceptions, with four healthy deliveries.
CONCLUSION(S): Women with early-stage diffuse uterine leiomyomatosis can be treated by hysteroscopic resection, which has the benefits of preserving the uterus successfully, conceding a limited recurrence rate, and yielding satisfactory reproductive outcomes.
DESIGN: Retrospective report.
SETTING: University hospital.
PATIENT(S): Five consecutive women of reproductive age with innumerable small-sized (0.5-3 cm) diffuse uterine myomas with profuse menorrhagia.
INTERVENTION(S): Use of hysteroscopic myomectomy to excise only myomas impinging into the endometrial cavity, while leaving other intramural myomas in place.
MAIN OUTCOME MEASURE(S): Postoperative synechiae, recurrence, menstrual amount, conception, and pregnancy outcome.
RESULT(S): A total of 10 hysteroscopic surgeries were performed, among which 1 patient had repeated adhesiolysis for postoperative synechiae, 2 experienced repeated myomectomy because of submucosal myoma recurrence, and 1 underwent a scheduled two-step procedure with gonadotropin-releasing hormone analogue treatment in between. The uterus was successfully preserved and a normal amount of menstruation was restored in all (5/5) patients. All (3/3) patients who wished to conceive had successful conceptions, with four healthy deliveries.
CONCLUSION(S): Women with early-stage diffuse uterine leiomyomatosis can be treated by hysteroscopic resection, which has the benefits of preserving the uterus successfully, conceding a limited recurrence rate, and yielding satisfactory reproductive outcomes.