Abstract
Background: We examined the safety of hysteroscopic resection of sessile submucous myoma over 5cm diameter.
Material and Methods: Hysteroscopic resection was performed in 32 women from October, 2006 to April, 2008. (group A: endometrial polyps in 15, group B:under 5cm diameter sessile submucous myoma in 13, group C: over 5cm diameter sessile submucous myoma in 4) Modified resectoscopic technique was used. Firstly we cut the endometrial mucosa that covers the myoma. After resected connecting tissue between myoma and normal muscle, the myoma was excised followed by ring forceps extraction. For each patient, pre- and postoperative hemoglobin (hgb) change, operating time, 3% D-sorbitol solution volume were recorded.
Results: One-step hysteroscopic myomectomy performed in all cases. The difference between the preoperative and postoperative Hgb was -0.33±0.9 g/dl (A), -1.18±0.5 (B), -2.25±0.3 (C). It was significantly change (p<0.05 Mann-Whitney U).
The operating time was significantly shorter in group B (41.9±28 min) than in group C (95.0±26 min p<0.05 ). D-sorbitol solution volume was significantly less in group B (7003±2060 ml) more than group C (13625±4643 ml p<0.05).
Conclusion: We should be operated on with care about bleeding and absorption of D-sorbitol solution in hysteroscopic resection of large myoma.
