Diagnostic considerations and surgical techniques for a large prolapsing submucosal myoma

The objectives of this video are to review important considerations for accurate diagnosis a prolapsing submucosal myoma, and highlight surgical techniques minimally invasive uterine-sparing vaginal myomectomy. Submucosal myomas have the potential prolapse through cervix as uterus attempts expel them from cavity. Symptoms include bleeding, pelvic pain, abnormal discharge. Thorough evaluation ensure an timely is essential avoid complications which hemorrhage, infection, sepsis. Given theoretical risk we do not recommend hysterectomy first line management even in patients who desire future fertility. Removal large myoma requires advanced skills morcellation hysteroscopy order minimal blood loss complete excision. Minimally adequate exposure, clamping stalk, “cone” technique, intracervical vasopressin, hysteroscopic evaluation, insertion intrauterine balloon. Appropriate diagnosis, knowledge critical optimizing outcomes avoiding with prolapsed myoma.