Objective: To assess the risks and benefits of myomectomies performed
by endouterine resection. Design: A retrospective analysis of 284 pati
ents, with histologically proven submucous myomas, operated on between
April 1984 and April 1993. Outcomes were analyzed by Kaplan-Meier sta
tistics. Setting: Author's private practice in University Medical Cent
er. Patients: The age ranged from 25 to 70 years. Interventions: All t
he interventions but one were performed entirely at one setting. Myoma
s ranged in diameter from 10 to 65 mm. Main Outcome Measures: Clinical
symptoms and hysteroscopic appearance. Results: Good anatomical and f
unctional results were achieved in 95.6% of cases during the first 6 p
ostoperative months, persisting in 94.6% at 1 year, in 89.7% at 2 year
s, in 87.8% at 3 years, in 83.0% at 4 years, in 76.3% at 5 years, in 7
3.2% at 6 years, and remained stable at 67.6% by greater than or equal
to 7 years. The only notable complication was one perforation, which
was repaired immediately. Endouterine resection did not. improve the o
utcome in patients with primary infertility but was of benefit in case
s of secondary infertility. Conclusions: Myomectomy by endouterine res
ection is a difficult but safe and worthwhile conservative interventio
n.