Clinical Review on 304 Cases of Hysteroscopic Myomectomy.

Nam, Gyeong Il; Moon, Young Gil; Chang, Hong Jun; Park, Sung Hwan; Kil, Myung Do; Kim, Chul

Obstet Gynecol Sci > Volume 49(2); 2006 > Article

Original Article

Korean Journal of Obstetrics & Gynecology 2006;49(2):415-423.
Published online: February 1, 2006

Clinical Review on 304 Cases of Hysteroscopic Myomectomy.

Gyeong Il Nam, Young Gil Moon, Hong Jun Chang, Sung Hwan Park, Myung Do Kil, Chul Kim

Department of Obstetrics and Gynecology, Dong-eui Medical Center, Busan, Korea. kcog@freechal,com

Abstract

OBJECTIVE
The aim of this study is to extend the indications of hysteroscopic myomectomy. METHODS: Total 304 women who had undergone hysteroscopic myomectomy between February 2001 and March 2005, were selected. Clinical characteristics, laboratory data and postoperative results were analyzed. RESULTS: Mean size of myoma is 3.5 cm, mean op. time is 47 minutes, mean deficit of distension media is 193 cc, types of distension media is URIONE(R) and normal saline, average duration of hospitalization is 4.9 days, average changes of Hb. is 1.5 g/dL, complications of op. were happended in 14 cases, that is uterine perforation (n=8), hyponatremia (n=2), pulmonary edema (n=2), delayed bleeding (n=2). CONCLUSION: The indications of hysteroscopic myomectomy can be extended. In case that patient want to preserve the uterus, deep myometrial embedded or pure intramural myoma might be resected hysteroscopically by single- or multi-step procedure. Hysteroscopic myomectomy performed at observational period may be alternative to hysterectomy in selected cases. In case of recurrence, repeat procedure may reduce the chance of hysterectomy. Intraoperative ultrasonographic guidance is an important procedure in hysteroscopic myomectomy. It lower the complications and morbidity rate.

Keywords: Hysteroscopic myomectomy; Transabdominal ultrasonographic guidance; Intramural myoma