SOME ASPECTS OF HYSTEROSCOPIC SURGICAL TREATMENT OF SUBMUCOUS UTERINE MYOMA

Abstract

Aim. To improve the results of hysteroscopic surgical treatment of submucous uterine myoma. Material and methods. The work is based on the analysis of the results of diagnosis and hysteroscopic treatment of 26 women with submucous uterine myoma. In order to determine the criteria for selecting the optimal method of hysteroscopic myomectomy, the classification of K. Wamsteker was applied. Nodes of type 0 were found in 7 (26.9%) cases, nodes of type I in 9 (34.6%) cases and patients with nodes of type II were observed in 10 (38.5%) cases. To clarify the endometrial pathology, diagnostic fluid hysteroscopy was performed before the intervention. Results. For each type of submucous node, an individual approach was applied. Taking into account the diameter, the localization, nodes were removed by 2mm and 4mm tools, vaporizing the nodes in combination with instrumental removal of destruction products, by monopolar electrosurgical resection, in one intervention with minimal blood loss. Conclusion. The instrumental technique of hysteroscopic myomectomy without prior suppression of the endometrium and myometrium, in more than 80% of cases provides primary radical removal of submucous nodes of all types, without additional application of vaporization.