Ivan Mazzon1, Alessandro Favilli2, Mario Grasso1, Stefano Horvath1, Vittorio Bini2, Gian Carlo Di Renzo2, Sandro Gerli3. 1. "Arbor Vitae" Centre, Clinica Nuova Villa Claudia, 00191 Rome, Italy. 2. Department of Obstetrics and Gynecology, University of Perugia, S.M. Della Misericordia Hospital, 06156 Perugia, Italy. 3. Department of Obstetrics and Gynecology, University of Perugia, S.M. Della Misericordia Hospital, 06156 Perugia, Italy. Electronic address: sandro.gerli@unipg.it.
Abstract
INTRODUCTION: Submucous myomas represent one of the main indications of operative hysteroscopy. Hysteroscopic resection of submucous fibroids should be a simple, well-tolerated and effective procedure and ideally accomplished in in only one surgical step. METHODS: Retrospective cohort single Centre study of 1244 women undergoing hysteroscopic myomectomy. Data analysis included patients' and the myomas characteristics. A multiple logistic regression was carried out in order to assess which variables were able to determine a multiple step procedure. RESULTS: 1090 myomas (87.62%) were completely resected in a single-step procedure (SS group) whereas a multiple-step procedure (MS group) was needed for the removal of 154 fibroids (12.38%). The mean size of myomas resected in the SS group was 22.83 ± 9.36 mm whereas fibroids of the MS group measured 29.67 ± 10.76 mm. The overall feasibility of hysteroscopic myomectomy in one surgical procedure was 88.28%. All hysteroscopic myomectomies of G0 fibroids were completed in a single step. The chance of success to accomplish the treatment in a single-step for G1 and G2 myomas were 88.59% and 82.55%, respectively. The multivariate analysis revealed an inverse correlation between age and multiple step procedures and size of myomas were all directly correlated to multiple step procedures. CONCLUSION: The grading, the size of the myomas and the age of patients play a crucial role in completing the hysteroscopic myomectomy in a single step. Only the diameter greater than 3 cm in G2 myomas is correlated to a higher risk of a multiple procedure.
INTRODUCTION:Submucous myomas represent one of the main indications of operative hysteroscopy. Hysteroscopic resection of submucous fibroids should be a simple, well-tolerated and effective procedure and ideally accomplished in in only one surgical step. METHODS: Retrospective cohort single Centre study of 1244 women undergoing hysteroscopic myomectomy. Data analysis included patients' and the myomas characteristics. A multiple logistic regression was carried out in order to assess which variables were able to determine a multiple step procedure. RESULTS: 1090 myomas (87.62%) were completely resected in a single-step procedure (SS group) whereas a multiple-step procedure (MS group) was needed for the removal of 154 fibroids (12.38%). The mean size of myomas resected in the SS group was 22.83 ± 9.36 mm whereas fibroids of the MS group measured 29.67 ± 10.76 mm. The overall feasibility of hysteroscopic myomectomy in one surgical procedure was 88.28%. All hysteroscopic myomectomies of G0 fibroids were completed in a single step. The chance of success to accomplish the treatment in a single-step for G1 and G2 myomas were 88.59% and 82.55%, respectively. The multivariate analysis revealed an inverse correlation between age and multiple step procedures and size of myomas were all directly correlated to multiple step procedures. CONCLUSION: The grading, the size of the myomas and the age of patients play a crucial role in completing the hysteroscopic myomectomy in a single step. Only the diameter greater than 3 cm in G2 myomas is correlated to a higher risk of a multiple procedure.
Authors: Aymara Mas; Marta Tarazona; Joana Dasí Carrasco; Gloria Estaca; Ignacio Cristóbal; Javier Monleón Journal: Int J Womens Health Date: 2017-09-05
Authors: Ivan Mazzon; Alessandro Favilli; Mario Grasso; Stefano Horvath; Vittorio Bini; Gian Carlo Di Renzo; Sandro Gerli Journal: Biomed Res Int Date: 2018-05-20 Impact factor: 3.411
Authors: Salvatore Giovanni Vitale; Fabrizio Sapia; Agnese Maria Chiara Rapisarda; Gaetano Valenti; Fabrizia Santangelo; Diego Rossetti; Benito Chiofalo; Giuseppe Sarpietro; Valentina Lucia La Rosa; Onofrio Triolo; Marco Noventa; Salvatore Gizzo; Antonio Simone Laganà Journal: Biomed Res Int Date: 2017-08-29 Impact factor: 3.411