A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases

Objective: To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the convention...

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Main Authors: Wataru Isono, Masanori Maruyama
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:European Journal of Obstetrics & Gynecology and Reproductive Biology: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590161324000747
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author Wataru Isono
Masanori Maruyama
author_facet Wataru Isono
Masanori Maruyama
author_sort Wataru Isono
collection DOAJ
description Objective: To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the conventional hysteroscopic myomectomy (C-HM). Study Design: The data from 94 patients aged 42 or younger who underwent HM (38 cases with UEP-HM and 56 cases with C-HM) for treating single Type 1 or Type 2 submucosal leiomyoma (SL) were analysed retrospectively for comparing the characteristics of both patient and target SL. In this process, we defined the operation time 60 min or over as the longtime operation (LTO) and the SM sized 3 cm or over as the large submucosal leiomyoma (LSL) for detecting the influential factors, including this procedure, on the difficulty of HM. For assisting the prediction of operation time (OT), we investigated the relationship between the OT and the cube of average diameter (AD) of target SL referring with some past reports. Results: Although when comparing UEP and control groups, parity, AD, the number of patients with Type 2 SL, OT, and the number of infertile patients showed significant difference, in the multivariate analysis only LSL showed the significant influence on the possibility of LTO. Next, we compared OT/Cube of AD, which calculated by dividing OT by the cube of AD for evaluating OT from the target SL size and confirmed that there was no difference in those 2 groups (3.7 ± 3.0 (95 %CI: 0.9 - 13.3, n = 38) vs. 3.9 ± 3.2 (95 %CI: 0.4 - 17.3, n = 56), p = 0.79). Conclusions: The new UEP-HM can become an alternative method of C-HM without procedure-specific difficulty. In the future, to investigate the prognosis of this procedure, more patients and further analyses should be accumulated.
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spelling doaj-art-693116e35fa24d19baee877e1572f70c2024-12-14T06:32:44ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132024-12-0124100354A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 casesWataru Isono0Masanori Maruyama1Department of Obstetrics and Gynaecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, 5-1-1, Futago, Takatsu-Ku, Kawasaki, Kanagawa 213-8507, Japan; Department of Obstetrics and Gynecology, Maruyama Memorial General Hospital, 2-10-5, Honchou, Iwatsuki-ku, Saitama City, Saitama 339-8521, Japan; Corresponding author at: Department of Obstetrics and Gynaecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, 5-1-1, Futago, Takatsu-Ku, Kawasaki, Kanagawa 213-8507, Japan.Department of Obstetrics and Gynecology, Maruyama Memorial General Hospital, 2-10-5, Honchou, Iwatsuki-ku, Saitama City, Saitama 339-8521, JapanObjective: To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the conventional hysteroscopic myomectomy (C-HM). Study Design: The data from 94 patients aged 42 or younger who underwent HM (38 cases with UEP-HM and 56 cases with C-HM) for treating single Type 1 or Type 2 submucosal leiomyoma (SL) were analysed retrospectively for comparing the characteristics of both patient and target SL. In this process, we defined the operation time 60 min or over as the longtime operation (LTO) and the SM sized 3 cm or over as the large submucosal leiomyoma (LSL) for detecting the influential factors, including this procedure, on the difficulty of HM. For assisting the prediction of operation time (OT), we investigated the relationship between the OT and the cube of average diameter (AD) of target SL referring with some past reports. Results: Although when comparing UEP and control groups, parity, AD, the number of patients with Type 2 SL, OT, and the number of infertile patients showed significant difference, in the multivariate analysis only LSL showed the significant influence on the possibility of LTO. Next, we compared OT/Cube of AD, which calculated by dividing OT by the cube of AD for evaluating OT from the target SL size and confirmed that there was no difference in those 2 groups (3.7 ± 3.0 (95 %CI: 0.9 - 13.3, n = 38) vs. 3.9 ± 3.2 (95 %CI: 0.4 - 17.3, n = 56), p = 0.79). Conclusions: The new UEP-HM can become an alternative method of C-HM without procedure-specific difficulty. In the future, to investigate the prognosis of this procedure, more patients and further analyses should be accumulated.http://www.sciencedirect.com/science/article/pii/S2590161324000747Uterine endometrium preservation hysteroscopic myomectomyOperation timeAverage diameterLarge submucosal leiomyoma
spellingShingle Wataru Isono
Masanori Maruyama
A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
European Journal of Obstetrics & Gynecology and Reproductive Biology: X
Uterine endometrium preservation hysteroscopic myomectomy
Operation time
Average diameter
Large submucosal leiomyoma
title A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
title_full A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
title_fullStr A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
title_full_unstemmed A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
title_short A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases
title_sort new uterine endometrium preservation hysteroscopic myomectomy introduction of improved procedures and a retrospective analysis of 94 cases
topic Uterine endometrium preservation hysteroscopic myomectomy
Operation time
Average diameter
Large submucosal leiomyoma
url http://www.sciencedirect.com/science/article/pii/S2590161324000747
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