- Author:
Karen Therese Abalos-Gaddi
1
;
Maria Antonia E. Habana
1
Author Information
- Publication Type:Journal Article
- Keywords: Submucous Myoma
- MeSH: Human; Female; Fibroids; Leiomyoma; Hysteroscopy; Myomectomy; Uterine Myomectomy
- From: Philippine Journal of Obstetrics and Gynecology 2024;48(4):235-244
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND
Hysteroscopic myomectomy is regarded as the gold standard in the management of intracavitary myomas. With its increased use, it is essential to explore its effectiveness for better therapeutic planning and patient selection.
OBJECTIVESThis study aimed to determine the effectiveness of hysteroscopic myomectomy performed in a tertiary hospital in the Philippines.
METHODSA retrospective cross-sectional study of women who underwent hysteroscopic myomectomy in 5 years was performed.
RESULTSA total of 167 women were included. Completeness of resection was achieved in 88.46% of the cases. In the final multivariate model, older age, pretreatment with gonadotropin-releasing hormone (GnRH) agonist, and lesser total fluid input were associated with increased odds of complete resection. Submucous myoma at least 3 cm in size had greater total fluid input, greater blood loss, the presence of complications, and a greater need for transfusion. Pretreatment with GnRH agonists had more International Federation of Gynecology and Obstetrics Grade 1 and 2 myoma, higher frequency of ≥3 myomas, lower frequency of complete resection, and increased operative time compared to those without pretreatment with GnRH agonists. Pretreatment with other hormonal therapy had a lesser need for transfusion compared to those without pretreatment with hormonal therapy.
CONCLUSIONSHysteroscopic myomectomy is a generally safe and effective procedure for the treatment of submucous myomas. The odds of complete resection are greater with older age and decreased with pretreatment with GnRH agonist and more distention fluid used. Larger submucous myoma was associated with greater total fluid input and blood loss, more complications, and greater need for transfusion. Pretreatment with GnRH agonist had no significant benefit and was associated with longer surgical time and lesser complete resection.
- Full text:2025010613282442395PJOG3.pdf