Fibroids and Hysteroscopy: An Overview

Abstract

Submucosal fibroids account for 10% of total fibroids. They significantly impact quality of life causing abnormal uterine bleeding (AUB), reduction in fertility rates/infertility, obstetrics complications and abdominal pain. They are a major public health concern because of economic cost their monitoring and treatment requires. Hysteroscopic myomectomy is the first line minimally invasive and conservative surgical treatment. Treating a fibroid correctly implies knowing its physiopathology: What is a submucosal fibroids and what is its origin, what is the Pseudocapsule?. Proper diagnosis and standardized classification such as the Wamsteker classification are required. What are the limits to perform a hysteroscopic myomectomy? What devices are currently used? What are the requirements for conducting myomectomy procedures in the outpatient setting?. Different forms of surgical approach. Complications and consequences of a myomectomy. What will we do in the future with the management of small submucosal fibroids in asymptomatic patients with future genetic desires and can we resect type 3 fibroids by hysteroscopy avoiding a higher risk surgery by abdominal route?