|Discussion in 'All Categories' started by Sweta Tiwari - Nov 8th, 2011 8:25 pm.|
|I am suffering from sumucous myoma can it be performed by hysteroscopy and can you let me know how exactly it is done.|
re: Submucous Myoma by Dr JS Chauhan - Nov 8th, 2011 8:29 pm
Dr JS Chauhan
|Dear Mrs. Sweta Tiwari
Hysteroscopic removal of submucous myoma is an ideal procedure which can be performed by a good gynecologysts. Uterine fibroids which are completely or partially inside the cavity from the uterus (submucous myomas) can often be removed with the cervix while on an instrument called a resectoscope.
A resectoscope is a special type of hysteroscope that uses a loop powered by high-frequency electrical energy to chop with the fibroid. Since the instrument experiences the cervix, no incision is essential.
This is generally done as an outpatient, and recovery typically takes a few days until most normal activity can be resumed.
Selection of patients to whom hysteroscopic elimination of fibroids is suitable is one of the most important factors in obtaining great results. Factors to consider are the size and number of fibroids, location, the share that's in the cavity and percentage that's within the wall (intramural) or the uterus, the chance that other intramural or subserous myomas would remain, and the desire for future pregnancy are some of the factors to be considered.
Fibroids that are entirely inside the uterine cavity would be the easiest to resect, and a very experienced gynecologist may be able to resect these as much as 5 cm in diameter. Most submucous fibroids are partially in the wall from the uterus.
The illustration above shows a fibroid that is about 2/3 within the cavity and 1/3 in the wall. During the process of resecting this the uterus often contracts, squeezing out the portion that is within the wall, and allowing more complete removal.
The photo below shows a sizable fibroid that is over 50 percent within the wall, as determined by MRI. This is easily the most difficult type of fibroid to get rid of hysteroscopically, especially if it is toward the top uterus.
Submucous Uterine Fibroid over 50 percent intramural. The loop is used to resect the fibroid, bite by bite, (photo on the left) until it is level using the surface. In this example a unique medication was used to help the uterus contract so virtually all of the fibroid might be squeezed in to the cavity, allowing me to totally remove it. The right photo shows the shell of where the myoma was. This will cover over and done with endometrium (the liner from the uterus). When we look at this area in a number of months with office hysteroscopy be also capable of seeing where the fibroid used to be.
Dr JS Chauhan
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