Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
London NW3 2QG, UK


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A new website for gynaecologists interested in the surgical management of fibroids is now on line.

Hysteroscopic myomectomy

Hysteroscopic myomectomy is done using a small telescope inserted through the vagina and cervix into the uterus. The telescope can be fitted with miniature instruments (eg. scissors, cutting loop, laser) which is used to remove or destroy the fibroid(s). The procedure is monitored on a colour television via a small video camera.

This type of surgery is suitable for small fibroids which are mainly sited inside the cavity of the uterus, although deeper fibroids can sometimes also be removed. With larger fibroids, the procedure may have to be repeated, but this is unusual. Complications with this type of surgery are relatively uncommon.

Relatively minor (day case) surgery
No external scars
Complications uncommon
Fast recovery
No risk of scar tissue in pelvis
Only suitable for small/few fibroids
Fibroids have to be mainly in the uterine cavity

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Operative hysteroscopy

Hysteroscopy can also be used for treatment. Operative hysteroscopes are slightly larger instrument fitted with mechanical instruments (e.g. scissors, biopsy forceps, graspers), electrodes (e.g. resectoscope) or laser.

One of the most effective hysteroscopic procedures is myomectomy. Fibroids are usually excised but can also be vaporised. This type of surgery is indicated provided the fibroids are not too large or numerous, and situated mainly inside the uterine cavity.

Hysteroscopic surgery can also be used to remove polyps, divide uterine septa, free adhesions (Asherman's syndrome) and destroy the endometrium (endometrial ablation).