Hysteroscopic resection of a large submucosal fibroid using intermittent bimanual uterine massage and a bipolar resectoscope: A case report

Nikos F. Vlahos

    Research output: Contribution to journalArticlepeer-review

    Abstract

    BACKGROUND: Hysteroscopic resection of large submucosal myomas embedded deep in the myometrium is often unsuccessful due to absorption of large amounts of nonionic fluid that may result in water intoxication or incomplete resection of the intramural portion of the tumor, which later protrudes within the cavity. CASE: A 35-year-old woman with a large, sessile, submucosal leiomyoma underwent hysteroscopic resection using a bipolar resectoscope under laparoscopic monitoring with intermittent uterine massage. An isotonic electrolyte solution was used for uterine distention and visualization. Frequent massaging of the uterus during the procedure resulted in the expulsion of the fibroid into the endometrial cavity and facilitated complete resection. CONCLUSION: A bipolar resectoscope, which can be used with electrolyte solutions, such as 0.9% NaCl, combined with uterine massage, allows complete removal of large leiomyomas without adverse electrolyte imbalances.

    Original languageEnglish (US)
    Pages (from-to)543-546
    Number of pages4
    JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
    Volume50
    Issue number7
    StatePublished - Jul 1 2005

    Keywords

    • Fibroid tumor
    • Hysteroscopy
    • Uterine massage
    • Uterine neoplasms

    ASJC Scopus subject areas

    • Reproductive Medicine
    • Obstetrics and Gynecology

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