SINGLE-STAGE TOTAL HYSTEROSCOPIC MYOMECTOMIES - INDICATIONS, TECHNIQUES, AND RESULTS

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.