CHOICE OF ORGAN PRESERVING TREATMENT OF SUBMUCOUS UTERINE MYOMA BASED ON RATIONAL DIAGNOSTIC CRITERIA

Submucous uterine myoma differs from the other types of myoma with a high rate of complications. Among them menorrhagia, infertility and loss of pregnancy.

Impetuous progress of minimal invasive surgery demands the improvement of the diagnostic algorithms for patient with uterine benign tumors especially submucous myoma.

Widen criteria for submucous nodules assessment using ultrasound were offered in this study. It may give surgeons the opportunity to have clearer view about features of the operative treatment and as result to enhance the efficiency of pre- and intraoperative measures and of cause rehabilitation in early and late postoperative period.

We took several basic anatomical features of the submucous nodules: the penetration of the nodule into the myometrium, the size and the amount of nodules, the size of the surface that contacts with the myometrium, topography, vascularization. In each particular criteria we picked out the parameters of the complexity of hysteroscopic myomectomy for surgeon using balls from 0 to 3.

Analysis of the proposed system of submucous myoma assessment (SMAS) efficiency was made using retrospective study of randomly picked 64 hysteroscopic myomectomies.

The following conclusions were made. Proposed SMAS is rational, effective and understandable assessment of the anatomical features of the submucous nodules. SMAS is simple and quick way to evaluate the complexity of hysteroscopy and to choose the effective preoperative treatment when needed.