open access

Vol 89, No 7 (2018)
Review paper
Published online: 2018-07-31
Get Citation

Complications in modern hysteroscopic myomectomy

Michał Ciebiera1, Tomasz Łoziński2, Cezary Wojtyła1, Wojciech Rawski1, Grzegorz Jakiel1
DOI: 10.5603/GP.a2018.0068
·
Pubmed: 30091451
·
Ginekol Pol 2018;89(7):398-404.
Affiliations
  1. I Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education,, Warsaw, Poland
  2. Department of Obstetrics and Gynecology Pro-Familia Hospital, Rzeszów, Poland

open access

Vol 89, No 7 (2018)
REVIEW PAPERS Gynecology
Published online: 2018-07-31

Abstract

Uterine fibroids (UFs) are common benign tumors of the female genital tract, diagnosed in almost one-quarter of women of reproductive age. UFs may cause numerous clinical symptoms, including prolonged or heavy menstrual bleeding, pelvic pressure symptoms, pain, infertility and others. Submucous fibroids arise from the muscular part of the uterus and pen­etrate into the uterine cavity. They are mostly managed with the use of hysteroscopic myomectomy (HM), which provides direct visualization from the transcervical approach. The sheer number of HM standards and techniques is reason enough to review the available literature about HM-related complications. HM is a safe and effective treatment in patients with the normal size of the uterus and with no more than a few UFs. The procedure should not be initiated without adequate preparation and diagnosis, using the best methods available.

Abstract

Uterine fibroids (UFs) are common benign tumors of the female genital tract, diagnosed in almost one-quarter of women of reproductive age. UFs may cause numerous clinical symptoms, including prolonged or heavy menstrual bleeding, pelvic pressure symptoms, pain, infertility and others. Submucous fibroids arise from the muscular part of the uterus and pen­etrate into the uterine cavity. They are mostly managed with the use of hysteroscopic myomectomy (HM), which provides direct visualization from the transcervical approach. The sheer number of HM standards and techniques is reason enough to review the available literature about HM-related complications. HM is a safe and effective treatment in patients with the normal size of the uterus and with no more than a few UFs. The procedure should not be initiated without adequate preparation and diagnosis, using the best methods available.

Get Citation

Keywords

hysteroscopy, myomectomy, uterine fibroid, leiomyoma, complication

About this article
Title

Complications in modern hysteroscopic myomectomy

Journal

Ginekologia Polska

Issue

Vol 89, No 7 (2018)

Article type

Review paper

Pages

398-404

Published online

2018-07-31

DOI

10.5603/GP.a2018.0068

Pubmed

30091451

Bibliographic record

Ginekol Pol 2018;89(7):398-404.

Keywords

hysteroscopy
myomectomy
uterine fibroid
leiomyoma
complication

Authors

Michał Ciebiera
Tomasz Łoziński
Cezary Wojtyła
Wojciech Rawski
Grzegorz Jakiel

References (40)
  1. Stewart EA, Laughlin-Tommaso SK, Catherino WH, et al. Uterine fibroids. Nat Rev Dis Primers. 2016; 2: 16043.
  2. Munro MG, Critchley HOD, Broder MS, et al. FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011; 113(1): 3–13.
  3. Laughlin-Tommaso SK, Hesley GK, Hopkins MR, et al. Clinical limitations of the International Federation of Gynecology and Obstetrics (FIGO) classification of uterine fibroids. Int J Gynaecol Obstet. 2017; 139(2): 143–148.
  4. Lasmar RB, Barrozo PR, Dias R, et al. Submucous myomas: a new presurgical classification to evaluate the viability of hysteroscopic surgical treatment--preliminary report. J Minim Invasive Gynecol. 2005; 12(4): 308–311.
  5. Lasmar RB, Xinmei Z, Indman PD, et al. Feasibility of a new system of classification of submucous myomas: a multicenter study. Fertil Steril. 2011; 95(6): 2073–2077.
  6. Capmas P, Voulgaropoulos A, Legendre G, et al. Hysteroscopic resection of type 3 myoma: a new challenge? Eur J Obstet Gynecol Reprod Biol. 2016; 205: 165–169.
  7. Marret H, Fritel X, Ouldamer L, et al. CNGOF (French College of Gynecology and Obstetrics). Therapeutic management of uterine fibroid tumors: updated French guidelines. Eur J Obstet Gynecol Reprod Biol. 2012; 165(2): 156–164.
  8. Emanuel M. Hysteroscopy and the treatment of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology. 2015; 29(7): 920–929.
  9. Korkmazer E, Tekin B, Solak N. Ultrasound guidance during hysteroscopic myomectomy in G1 and G2 Submucous Myomas: for a safer one step surgery. Eur J Obstet Gynecol Reprod Biol. 2016; 203: 108–111.
  10. Namazov A, Karakus R, Gencer E, et al. Do submucous myoma characteristics affect fertility and menstrual outcomes in patients underwent hysteroscopic myomectomy? Iran J Reprod Med. 2015; 13(6): 367–372.
  11. Donnez J, Dolmans MM. Uterine fibroid management: from the present to the future. Hum Reprod Update. 2016; 22(6): 665–686.
  12. Ferrero S, Racca A, Tafi E, et al. Ulipristal Acetate Before High Complexity Hysteroscopic Myomectomy: A Retrospective Comparative Study. J Minim Invasive Gynecol. 2016; 23(3): 390–395.
  13. Agency EM. Women taking Esmya for uterine fibroids to have regular liver tests while EMA review is ongoing. ; 2018.
  14. van Kerkvoorde TC, Veersema S, Timmermans A. Long-term complications of office hysteroscopy: analysis of 1028 cases. J Minim Invasive Gynecol. 2012; 19(4): 494–497.
  15. Mazzon I, Favilli A, Grasso M, et al. Is Cold Loop Hysteroscopic Myomectomy a Safe and Effective Technique for the Treatment of Submucous Myomas With Intramural Development? A Series of 1434 Surgical Procedures. J Minim Invasive Gynecol. 2015; 22(5): 792–798.
  16. Aydeniz B, Gruber IV, Schauf B, et al. A multicenter survey of complications associated with 21,676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol. 2002; 104(2): 160–164.
  17. Jansen FW, Vredevoogd CB, van Ulzen K, et al. Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol. 2000; 96(2): 266–270.
  18. Munro MG, Christianson LA. Complications of Hysteroscopic and Uterine Resectoscopic Surgery. Clin Obstet Gynecol. 2015; 58(4): 765–797.
  19. Casadio P, Youssef AM, Spagnolo E, et al. Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question. Fertil Steril. 2011; 95(5): 1764–8.e1.
  20. Ludwin A, Ludwin I, Pityński K, et al. Transrectal ultrasound-guided hysteroscopic myomectomy of submucosal myomas with a varying degree of myometrial penetration. J Minim Invasive Gynecol. 2013; 20(5): 672–685.
  21. Issat T, Beta J, Januszewski M, et al. Cumulative summation test for learning curve (LC-CUSUM) in outpatient hysteroscopy. Ginekol Pol. 2017; 88(1): 9–12.
  22. Istre O. Managing bleeding, fluid absorption and uterine perforation at hysteroscopy. Best Pract Res Clin Obstet Gynaecol. 2009; 23(5): 619–629.
  23. Emanuel MH, Wamsteker K. The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas. J Minim Invasive Gynecol. 2005; 12(1): 62–66.
  24. Shokeir T, El-Lakkany N, Sadek E, et al. An RCT: use of oxytocin drip during hysteroscopic endometrial resection and its effect on operative blood loss and glycine deficit. J Minim Invasive Gynecol. 2011; 18(4): 489–493.
  25. Van Dongen H, Emanuel MH, Smeets MJ, et al. Follow-up after incomplete hysteroscopic removal of uterine fibroids. Acta Obstet Gynecol Scand. 2006; 85(12): 1463–1467.
  26. Closon F, Tulandi T. Future research and developments in hysteroscopy. Best Pract Res Clin Obstet Gynaecol. 2015; 29(7): 994–1000.
  27. Haber K, Hawkins E, Levie M, et al. Hysteroscopic morcellation: review of the manufacturer and user facility device experience (MAUDE) database. J Minim Invasive Gynecol. 2015; 22(1): 110–114.
  28. Storm BS, Andreasen S, Hovland A, et al. Gas Embolism During Hysteroscopic Surgery?: Three Cases and a Literature Review. A A Case Rep. 2017; 9(5): 140–143.
  29. Chen S, Chang A, Adkins C. Fertility after Myomectomy With the MyoSure Hysteroscopic Tissue Removal System. J Minim Invasive Gynecol. 2015; 22(6S): S191.
  30. Noventa M, Ancona E, Quaranta M, et al. Intrauterine Morcellator Devices: The Icon of Hysteroscopic Future or Merely a Marketing Image? A Systematic Review Regarding Safety, Efficacy, Advantages, and Contraindications. Reprod Sci. 2015; 22(10): 1289–1296.
  31. Food and Drug Administration. 2014. https://www.fda.gov/downloads/medicaldevices/safety/alertsandnotices/ucm393589.pdf..
  32. Bojahr B, De Wilde RL, Tchartchian G. Malignancy rate of 10,731 uteri morcellated during laparoscopic supracervical hysterectomy (LASH). Arch Gynecol Obstet. 2015; 292(3): 665–672.
  33. Lieng M, Berner E, Busund B. Risk of morcellation of uterine leiomyosarcomas in laparoscopic supracervical hysterectomy and laparoscopic myomectomy, a retrospective trial including 4791 women. J Minim Invasive Gynecol. 2015; 22(3): 410–414.
  34. Stachowicz N, Mazurek D, Łoziński T, et al. Diagnostic hysteroscopy and the risk of malignant cells intraabdominal spread in women with endometrial cancer. Ginekol Pol. 2017; 88(10): 562–567.
  35. Agostini A, Crochet P, Blanc K, et al. Postoperative infection and surgical hysteroscopy. Fertil Steril. 2002; 77(4): 766–768.
  36. Nappi L, Di Spiezio Sardo A, Spinelli M, et al. A multicenter, double-blind, randomized, placebo-controlled study to assess whether antibiotic administration should be recommended during office operative hysteroscopy. Reprod Sci. 2013; 20(7): 755–761.
  37. Umranikar S, Clark TJ, Saridogan E, et al. British Society for Gynaecological Endoscopy /European Society for Gynaecological Endoscopy Guideline Development Group for Management of Fluid Distension Media in Operative Hysteroscopy. BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy. Gynecol Surg. 2016; 13(4): 289–303.
  38. Munro MG, Storz K, Abbott JA, et al. AAGL Advancing Minimally Invasive Gynecology Worldwide. AAGL Practice Report: Practice Guidelines for the Management of Hysteroscopic Distending Media: (Replaces Hysteroscopic Fluid Monitoring Guidelines. J Am Assoc Gynecol Laparosc. 2000;7:167-168.). J Minim Invasive Gynecol. 2013; 20(2): 137–148.
  39. Brull SJ, Prielipp RC. Vascular air embolism: A silent hazard to patient safety. J Crit Care. 2017; 42: 255–263.
  40. Leibowitz D, Benshalom N, Kaganov Y, et al. The incidence and haemodynamic significance of gas emboli during operative hysteroscopy: a prospective echocardiographic study. Eur J Echocardiogr. 2010; 11(5): 429–431.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl