Hysteroscopic myomectomy, also called hysteroscopic resection, can be a myomectomy method of choice if the fibroids are all (intracavitary) or for the most part (submucosal) on the inner wall of the uterus. The instrument used is called the resectoscope, and it is a special kind of hysteroscope. Hysteroscope goes through the cervix and there is no need for an incision at all in this method. Hysteroscope is a tiny camera, and the resectoscope part is a wire loop, which removes the fibroid. If the fibroid is particularly large, two procedures may be needed.
Sometimes, the surgeon will prescribe Gonadotropin-releasing hormone (GnRH) agonists, such as Depot Lupron, to be taken a month or two in advance. That will shrink the fibroids while being taken. The downside of using Lupron is a temporary menopause, with symptoms such as hot flashes, sweating and the like.
Before inserting the hysteroscope, the uterus is filled with either saline or carbon dioxide. Then the cervix is numbed, and when the instrument is finally in, the surgeon can actually seE what is inside — myomas, polyps, or something else that can cause bleedings as well. The entire procedure takes a minute or two and can be done in the office.
With the advance of thinner and better accompanying instruments, operative hysteroscopy can, in many cases, be a means to avoid hysterectomy. The resectoscope is very efficient tool and it is recommended that it be used only by surgeons who have extensive experience with it.
Advantages and the Follow-up To Hysteroscopic Myomectomy
The greatest advantage of hysteroscopic myomectomy is quick recovery time. The entire procedure can be done in an outpatient surgery center, under local anesthesia, or — which is what majority of women preferrs — under general anesthesia. The patient will usually experience the pain and bleeding after the procedure, but nothing too strong that couldn’t be regulated by oral pain medications. However, if the pain is severe or bleeding is heavy and bright red, the patient should return to the hospital immediately. Other risks would be bleeding and infection, but all surgeries could have that as an aftereffect.
The Success Rates of Hysteroscopic Myomectomy
Intracavitary and submucosal fibroids tend to produce heavy bleedings and if the hysteroscopic myomectomy was done correctly, the heavy periods should stop in 80 and 90 percent of all cases. Successful removal of one fibroid does not mean that others won’t grow again. About 20 percent of women need another fibroid treatment within ten years. As with other types of myomectomies, fertility is (or should be) preserved. Where large fibroids prevented fertility, pregnancy rates were high after hysteroscopic myomectomy.
Resectoscope can also be used to perform endometrial ablation, which is destroying the uterine lining (endometrium). This will permanently stop menstrual bleeding and the growth of certain types of fibroids, but will also destroy fertility. Endometrial ablation preserves the uterus, but at the price of permanently being unable to conceive. It is only for the women who have completed their childbearing.
There are many other methods for endometrial ablation, and practically all are explained within this site. For a list of energy healing methods that can directly destroy myoma of uterus, without any surgery at all, please visit our fibroid treatments page.