Symptomatic submucous uterine fibroid: outcome of conservative surgery in a tertiary care hospital

Background: Leiomyoma are benign smooth muscle neoplasm’s that typically originate from the myometrium. The main objective was to evaluate the outcome of conservative surgical approach for submucous fibroid uterus is using prostaglandin preoperatively and gonadotropin releasing hormone (GnRh) in preoperative phase. Methods: Thirty eight patients who had hysteroscopic myomectomy with a resectoscope for submucous fibroid were studied at the department of Obstetrics and Gynecology of the Government Medical College, Chandigarh and PGIMSR, New Delhi, India. Results: Median age was 35 years (20 to 50). Abnormal uterine bleeding (AUB) was the most frequent indication (71.05%). Failure to conceive and repeated abortion was indication in 11 (28.94%) cases. GnRH analogue preparation was used in 8 (21.05%) of cases. A median of 37.10 (15 minutes to 60 minutes) minutes was required for the interventions. The myomectomy was combined with another operation in 15 patients. Complete resection was not possible in 4 patients, while 5 underwent a reoperation. No serious complications occurred, with satisfactory followup outcome as AUB was controlled in 89.48% of the patients. Conclusions: Hysteroscopic myomectomy is a reliable procedure that is effective in controlling abnormal uterine bleeding, even it can be done in larger submucous fibroid using GnRh analogue, and prostidin.