The urgency of the problem. Uterine fibroids take the second place in the structure of gynecological pathology after inflammatory processes.
Objectives. To analyze the results of hysteroscopic myomectomy in our center and to compare the results to those published in the literature.
Methods. There were conducted 90 cases of hysteroscopic myomectomy from September 2008 to November 2011. The group included patients who wanted to preserve the uterus with submucosal uterine myoma 5 cm in diameter, no more than 3 nodes and the absence of comorbidity, which would be a contraindication for this surgery. In every case, a basic gynecologic examination, anamnesis, smear, vaginal fortis, vaginal scan were carried out.
Results and discussion. The average age of patients was 36.2 years (range 23–67 years). The largest group was in the age group between 30 and 40 years (53.3%). The main reason for treatment was uterine bleeding — 68 (84.1%) patients, including 17.6% postmenopausal women. Infertility was observed in 16.6%. Pain was present in 11.1% of cases. In 86.6% of cases the diagnosis was confirmed by ultrasound. Preoperative GnRH analogues were carried out in 16 patients (17.8%). According to the classification used by us Wamsteker and de Blok, we obtained the following data: 0 type was detected in 28 patients (31.1%), I type — 49 (54.4%), II type — 13 (14.4%). In 23 cases, myomectomy has not been fully implemented. No serious complications were observed.
Conclusion. Hysteroscopic myomectomy is an extremely effective surgical treatment in controlling abnormal uterine bleeding. As an alternative to hysterectomy, does not show a great time of surgery, with minimal damage to surrounding tissue, and minimal hospital stays. The bases for reducing a minimum number of reinterventions are good patient selection and technique improvement.