I-23: The Role of Hysteroscopy in Sub Mucosal Myoma

Hysteroscopy is a method through which endometrial cavity can be observed and manipulated transcervically. The association of sub serous fibroids and intramural fibroids with infertility is controversial. But the role of sub mucous fibroids which are reported in 5%-18% of patients as a causal factor for infertility is likely. Sub mucous fibroids are postulated to cause menometrorrhagia, sub fertility and abortion. The study was conducted during a period of 4 years from April 2008 to March 2012. This was a prospective study. Overall 197 women underwent hysteroscopy were evaluated in three groups: with AUB 146 cases, with infertility 34 cases and with recurrent abortions 17 cases. The diagnostic tool was transvaginal ultrasound. The overall success rate was recorded and analyzed after six months in order of indication of hysteroscopy. The procedure of surgery with general or conductive anesthesia for inpatient management was done with misopristol premedication 200 microgram sublingually 2 hours before surgery the surgical equipment was rigid STORZ Hysteroresectope with zero and 30 degree lenses and the loop monopolar cutting devices. The mean patient age was 34 years (range: 26 to 42 years). The most common symptoms were menorrhagia which was present in 30% of patients, premenstrual spotting and infertility or abortion with endometrial mass in trans vaginal ultrasound. Conclusion: Hysteroscopic myomectomy is a safe procedure to enhance fertility especially in cases with symptomatic sub mucosal myoma.