Outpatient Hysteroscopic Emptying of a Submucosal Uterine Cystic Lesion

BACKGROUND Uterine cystic neoformations are rare, but they should always be investigated to differentiate a benign from a malignant pathology. Transvaginal ultrasonography, MRI, and blood tests are the main investigations for diagnosing these lesions, avoiding over- or undertreatment. Hysteroscopy might represent a helpful tool both for its diagnostic and therapeutic properties. METHODS We report the hysteroscopic emptying of a cystic-degenerated leiomyoma with a 5-Fr flexible needle inserted through the operative channel of a 5-mm continuous-flow operative office hysteroscope in an outpatient setting. RESULTS The cystic lesion was successfully emptied. The hystopathological result of the target biopsies performed on the cystic wall was cystic degeneration of a leiomyoma. CONCLUSION This needle is normally used in gynecology to instill intrauterine local anesthesia under a hysteroscopic view. We adapted it to drain a fluid-filled lesion, identifying a further application of this instrument.