Bleeding and Hysteroscopy in Uterine Myomatosis

Abstract

Uterine leiomyomas are one of the most common diseases in women. However, there is still much about them we do not know. These tumours, also known as fibroids or myomas, affect women mainly during their reproductive years, and they are diagnosed in up to 70% to 80% of women during their lives. The most relevant part of this disease is the profound impact in the quality of life of women, in the provision of health services, and on the costs all around the world. Even though, the majority of women with fibroids are asymptomatic, approximately 30% of them will present severe symptoms, with a broad range of problems such as: abnormal uterine bleeding, infertility, and obstetric complications. There are multiple factors involved in the biology of fibroids: genetic, epigenetic, hormonal, proinflammatory, angiogenic and growth factors, growth factors that are capable of inducing and promoting de development of fibroids. The leiomyoma is surrounded by a pseudocapsule generated by compression and ischaemia of the tumour towards the myometrium and is composed by multiple elements that that promote healing and tissue repair of the myometrium after myomectomy. Therefore, its conservation in the myometrium is essential, regardless of the surgical technique used. Resection by hysteroscopy can be performed in an office or in an operating room, depending on the characteristics of the fibroid, it is required a good diagnosis and experience.