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Korean Journal of Obstetrics & Gynecology 2002;45(7):1155-1158.
Published online July 1, 2002.
Vaginal Removal of the Pedunculated Submucous Myoma: Twisting-off Method.
Hee Jung Go, Eun Kyeong Baek, You Sung Lee, Chang Ho Lee, Jae Duk Kim, Ho Myong Hwang, Jae Kyun Doo
Department of Obstetrics and Gynecology, College of medicine, Chonbuk National University, Chonju, Korea.
Abstract
OBJECTIVE
To evaluate the efficacy of the twisting-off method in transvaginal removal of the pedunculated submucous myoma. METHODS: After paracervical block and vaginal dressing with Povidone iodine, the myoma was grasped at its widest diameter and twisted to avulse it from its attatchment. Several kinds of grasping instruments, ie. kelley clamp, tenaculum, ring forcep, was used. If there was bleeding from its detachment site, vaginal gauze or tampon was inserted for bleeding control. RESULTS: The procedure was perfomed successfully on all 33 patients (100%). In most patients, bleeding was scanty in amount. But in one patient, emergency hysterectomy was performed because of massive uterine bleeding. The myoma varied greatly in size. Largest volume was 62.24 cm3, and mean volume was 13.79 cm3. Pathology revealed classic leiomyomas in most cases. Some showed endocervical polyp or endometrial polyp. Follow up examination was done, and its mean interval was eighteen weeks and no patient was recurred. CONCLUSION: The transvaginal removal of pedunculated submucous myoma utilizing grasping instruments may be an effective and safe procedure and the complication is minimal. Twisting-off method was may be a safe alternative to abdominal myomectomy and hysterectomy. Reproductive capacity can be preserved, also.
Key Words: Twisting-off method, pedunculated submucous myoma
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