Objectives: To evaluate outcome of submucous myomectomy using the Hologic MyoSure® hystroscopic tissue removal system (HTRS) and to determine its effect on patients' quality of life (QOL).
Patients & Methods: This prospective-retrospective study included 24 women in childbearing period who presented by abnormal uterine bleeding (AUB) secondary to uterine fibroid (UF). Women were clinically evaluated and then underwent transvaginal fluid–infused ultrasonography for measuring fibroid size and extent of myometrial invasion and only women with UF of Stage 0 or 1 according to FIGO classification were enrolled in the study. Similar data of patients had submucous UF resected by conventional hysteroscopic monopolar loop resectoscope were extracted off files. Intraoperative (IO) data included operative time and amount IO bleeding and of distending fluid. PO pain was graded using Likert 5-point scale and moderate-to-severe pain was managed using intramuscular morphine. At 6th month of follow-up hemoglobin concentration (Hb. Conc.) was re-estimated and percentage of improvement in relation to preoperative concentration was calculated. Patients' satisfaction concerning the impact of uterine bleeding on QOL was evaluated using the SF-36 questionnaire.
Results: Mean operative time was significantly shorter with significantly lesser amount of blood loss, but significantly higher amount of distending fluid in comparison to corresponding data of control patients. Nine patients required rescue analgesia; 3 in study versus 6 in control groups and mean duration of hospital stay was non-significantly shorter in study patients. PO SF-36 score was significantly higher in comparison to preoperative scoring. Percentage of increase of Hb. Conc. was significantly higher in study compared to control patients. Conclusion: Myomectomy for stage 0-1 UF with |
