Resección histeroscópica de septo uterino conformado por mioma submucoso / Hysteroscopy Resection of the Uterine Septum Due To Submucosal Myoma

Las malformaciones uterinas congénitas presentan una baja prevalencia en la población general (0,5-6,7 por ciento), el útero septo es la más frecuente. Estas enfermedades pueden afectar a los resultados reproductivos de las pacientes, así como aumentar la incidencia de abortos de repetición, presentaciones fetales anómalas o partos pretérminos. De la misma forma, los miomas uterinos submucosos también pueden producir alteraciones de la fertilidad, aunque la sintomatología más relacionada con los mismos es el sangrado. Constituyen el tumor benigno más frecuente del aparato genital femenino. El diagnóstico de estas patologías puede realizarse mediante pruebas de imagen como la ecografía transvaginal y la resonancia magnética, aunque la visualización directa vía histeroscópica sigue siendo de elección. Esta técnica constituye, además, la primera opción terapéutica, ya que se puede realizar tanto la resección del septo uterino como la miomectomía, sin apenas complicaciones y mediante una técnica quirúrgica segura y poco invasiva. El tratamiento histeroscópico está especialmente indicado en pacientes sintomáticas, con esterilidad o abortos de repetición, incluso antes de iniciar terapias de reproducción asistida. En el siguiente trabajo exponemos el caso de una paciente que presentaba un septo uterino constituido en su mayor parte por un leiomioma submucoso tratado vía histeroscópica; siendo un caso muy raro, dada la infrecuente asociación entre ambas patologías(AU)

Congenital uterine malformations present low prevalence in the general population (0.5-6.7 percent), and uterus septum is the most frequent. These pathologies can affect the reproductive outcomes of patients, as well as increase the incidence of repeating abortions, abnormal fetal presentations or preterm deliveries. In the same way, submucosal uterine fibroids can also produce alterations in fertility, although the most related symptomatology is bleeding. They are the most frequent benign tumor of the female genital tract. Diagnosis can be carried out through imaging tests such as transvaginal ultrasound and magnetic resonance imaging, although direct visualization, via hysteroscopy, is still the preferred option. This technique is also the first therapeutic option, since both, resection of the uterine septum and myomectomy can be performed with few complications and a safe and minimally invasive surgical technique. Hysteroscopy is especially indicated in symptomatic patients, with sterility or repeated abortions, even before initiating assisted reproduction therapies. In the following paper, we present the case of a patient who presented a uterine septum formed mostly by a submucosal leiomyoma. She was treated by hysteroscopy. This case is very rare given the infrequent association between both pathologies(AU)

Treatment of submucous leiomyomas and endometrial polyps by hysteroscopic resection / 中国微创外科杂志

Objective To study the feasibility,safety,and efficacy of hysteroscopic treatment of submucous leiomyomas and endometrial polyps.Methods Hysteroscopic resections were performed in 38 cases of submucous leiomyomas and 40 cases of endometrial polyps from January 2002 to July 2004,including 31 cases of transcervical resection of myoma(TCRM),7 cases of TCRM combined with transcervical resection of the endometrium(TCRE), 35 cases of transcervical resection of polyp(TCRP),and 5 cases of TCRP combined with TCRE.Results The operation was completed smoothly on one session in all the 78 cases.The intraoperative blood loss was ≥ 400 ml in 2 cases.There were 1 case of overhydration.No uterine perforation or infection occurred after operation.The patients were followed at 1,3,6,and 12 months after operation,respectively,and the surgical outcomes were assessed at 12 postoperative months.Follow-up findings revealed 8 cases of amenorrhea(10.3%),12 cases of irregular spotting(15.4%),33 cases of hypomenorrhea(42.3%),22 cases of normal menstrual flow(28.2%),and 3 cases of no improvement(3.8%).Conclusions Hysteroscopic resections for submucous leiomyomas and endometrial polyps offer advantages of good reliability and fewer complications,being worthy of recommendation.