Successful pregnancies in women with diffuse uterine leiomyomatosis after hysteroscopic management.

Abstract:

OBJECTIVE:To describe the surgical and reproductive outcomes of early diffuse uterine leiomyomatosis with hysteroscopic myomectomy. DESIGN:Retrospective report. SETTING:University hospital. PATIENT(S):Five consecutive women of reproductive age with innumerable small-sized (0.5-3 cm) diffuse uterine myomas with profuse menorrhagia. INTERVENTION(S):Use of hysteroscopic myomectomy to excise only myomas impinging into the endometrial cavity, while leaving other intramural myomas in place. MAIN OUTCOME MEASURE(S):Postoperative synechiae, recurrence, menstrual amount, conception, and pregnancy outcome. RESULT(S):A total of 10 hysteroscopic surgeries were performed, among which 1 patient had repeated adhesiolysis for postoperative synechiae, 2 experienced repeated myomectomy because of submucosal myoma recurrence, and 1 underwent a scheduled two-step procedure with gonadotropin-releasing hormone analogue treatment in between. The uterus was successfully preserved and a normal amount of menstruation was restored in all (5/5) patients. All (3/3) patients who wished to conceive had successful conceptions, with four healthy deliveries. CONCLUSION(S):Women with early-stage diffuse uterine leiomyomatosis can be treated by hysteroscopic resection, which has the benefits of preserving the uterus successfully, conceding a limited recurrence rate, and yielding satisfactory reproductive outcomes.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Yen CF,Lee CL,Wang CJ,Soong YK,Arici A

doi

10.1016/j.fertnstert.2007.01.100

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1667-73

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(07)00203-8

journal_volume

88

pub_type

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