Hysteroscopic Myomectomy for the Treatment of Submucosal Leiomyomas: A Systematic Review of Outcomes

Abstract

Introduction: Submucosal leiomyomas (fibroids) are a common cause of heavy menstrual bleeding and infertility. Hysteroscopic myomectomy is the standard minimally invasive surgical treatment. This review evaluates its effectiveness and safety.

Methods: A systematic review of prospective case series and cohort studies was conducted. We included studies reporting on hysteroscopic resection of submucosal fibroids. Primary outcomes were resolution of bleeding symptoms, postoperative conception rates, and procedure-related complications.

Results: The review of over 50 studies showed that hysteroscopic myomectomy is highly effective, with complete resolution of heavy menstrual bleeding reported in 80-90% of patients. In women with infertility attributed to the fibroid, conception rates were approximately 50-60%. The rate of major complications, such as uterine perforation and fluid overload, was low.

Discussion: Hysteroscopic myomectomy is a safe and effective procedure that resolves the primary symptoms of submucosal fibroids while preserving the uterus. It is the treatment of choice for women with this condition, particularly those desiring future fertility.

Conclusion: Hysteroscopic myomectomy is a highly effective and safe procedure for treating symptomatic submucosal fibroids.