An alternative for hysteroscopic myomectomy: Ultrasound-guided single-step myomectomy for submucous myoma uteri with ring forceps, a retrospective study.

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Ozcivit Erkan I. B., Kuru O., Acar I., Oztas A. M., Gezer A.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, cilt.169, sa.3, ss.1217-1224, 2025 (SCI-Expanded, Scopus)

• Yayın Türü: Makale / Tam Makale
• Cilt numarası: 169 Sayı: 3
• Basım Tarihi: 2025
• Doi Numarası: 10.1002/ijgo.16179
• Dergi Adı: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
• Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Gender Studies Database, Public Affairs Index
• Sayfa Sayıları: ss.1217-1224
• İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Objective: Hysteroscopic myomectomy is widely regarded as safe and feasible, although

achieving single-session

results for larger myomas often requires alternative

methods. This study introduces a novel approach: ultrasound-guided

myoma extirpation

using ring forceps combined with hysteroscopy.

Methods: This retrospective, single-center

study includes patients who underwent

ultrasound-guided

myoma extirpation between 2016 and 2024. Data were collected

retrospectively, and myomas were classified according to the International Federation

of Gynecology and Obstetrics leiomyoma subclassification system. Under ultrasound

guidance, the myoma was extirpated using ring forceps. The pre-,

peri-,

and postoperative

outcomes were recorded and analyzed.

Results: A total of 25 patients were included, with a mean age of 44.76 ± 8.09 years.

Most patients (92%) were premenopausal, and the primary symptoms were irregular

bleeding (76%) and menorrhagia (68%). The median myoma size was 3 cm (interquartile

range [IQR]: 2–4 cm). The median operation time was 30 min (IQR: 20–42 min). There

was no statistically significant correlation between the duration of the operation and

the diameter of the myoma uteri. Most myomas were located in the fundus, left side,

or anterior wall (20% each), with 60% classified as type 0. Postoperative assessments

revealed no residual myomas in 84% of cases. Uterine perforation and cervical laceration

occurred as complications in two cases, while four cases required an additional

session. Two patients with infertility achieved full-term

pregnancies post-surgery.

Conclusion: This new, minimally invasive technique might be a feasible option for

large myomas, particularly in low-resource

settings. It minimizes the need for multiple

sessions, providing reassuring results for patients with suitable indications.