{"id":399,"date":"2023-09-21T14:54:59","date_gmt":"2023-09-21T12:54:59","guid":{"rendered":"https:\/\/www.isteroscopia.it\/?page_id=399"},"modified":"2023-11-03T14:43:54","modified_gmt":"2023-11-03T13:43:54","slug":"miomectomia-isteroscopica","status":"publish","type":"page","link":"https:\/\/www.isteroscopia.it\/en\/isteroscopia-operativa\/miomectomia-isteroscopica\/","title":{"rendered":"Hysteroscopic myomectomy"},"content":{"rendered":"
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Operative hysteroscopy<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Submucosal Myomas and Hysteroscopic Myomectomy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Occurs in 20-50% women (especially in perimenopausal age)<\/h3>

Symptomatology:\u00a0\u00a0<\/p>

  1. a.u.b. (abnormal menstrual and intermenstrual uterine bleeding)\u00a0<\/li>
  2. Sense of weight and pelvic pain<\/li>
  3. Volumetric increase at subsequent controls<\/li>
  4. Compression symptoms (feeling of weight)<\/li>
  5. Sterility or abortive<\/li><\/ol>

    \u00a0<\/p>

    Myomas of hysteroscopic relevance are only submucosal ones that are divided into:<\/p>

    1. G0 myoma: completely endocavitary myoma<\/li>
    2. G1 and G2 myoma with more or less than 50% intrauterine development.<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      When is it necessary to operate on a submucosal myoma?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      • Always if a woman wishes to become pregnant (the presence of a myoma can cause sterility or miscarriages)<\/li>
      • Always if it is symptomatic (i.e. if it causes continuous, heavy menstruation, bleeding outside menstruation)<\/li><\/ul>

        Before operating on a submucosal myoma, it is essential to determine its size, location, number, intramural development, distance from the external surface of the uterus<\/p>

        Pre-surgical diagnosis and evaluation is done with:<\/strong><\/p>

        A) Outpatient hysteroscopy, which allows evaluation:<\/p>

        1. The intracavitary portion of the myoma<\/li>
        2. Its location<\/li>
        3. The characteristics of the endometrium<\/li>
        4. Any associated intracavitary pathologies<\/li><\/ol>

          B) Transvaginal ultrasound or sonohysterography allows the evaluation of<\/p>

          1. The actual size of the myoma and the location especially if it is intramural<\/li>
          2. The 'myometrial free margin', i.e. the thickness of the myometrium above the myoma<\/li>
          3. The presence of other associated pathology (subserous myomas, ovarian cysts<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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            \"Mioma
            Submucosal myoma<\/figcaption><\/figure><\/div>
            \"Mioma
            Submucosal myoma<\/figcaption><\/figure><\/div>
            \"Mioma
            Submucosal myoma<\/figcaption><\/figure><\/div>
            \"MIOMA<\/figure><\/div>
            \"Mioma
            Myoma I.M. Fundico<\/figcaption><\/figure><\/div>\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t
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            The operating technique must have the following objectives<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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            • Total removal of myoma\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/li>
            • Respect for uterine anatomical integrity<\/li><\/ul>

              It recognises the following phases<\/h3>
              1. G0 myoma: resection of the myoma until its complete removal<\/li>
              2. G1 and G2 myomas: resection of the endocavitary part with thermal loops and of the intramural part with cold loops, a complex operation depending on whether the development is partially or predominantly intramural and which requires proven operator skill and the use of various types of loops with different functions<\/li>
              3. Complete removal of the myoma in no more than two stages. Any other solution proposed or implemented carries the risk of not resolving the symptoms.<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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                Isteroscopia Operativa Miomi Sottomucosi e Miomectomia Isteroscopica Si presenta nel 20-50% delle donne ( specie in et\u00e0 perimenopausale) Sintomatologia:\u00a0\u00a0 a.u.b.(sanguinamenti uterini anomali mestruali e intermestruali)\u00a0 Senso di peso e dolore pelvico Incremento volumetrico a successivi controlli Sintomi da compressione (senso di peso) Sterilit\u00e0 o abortivit\u00e0 \u00a0 I Miomi di pertinenza isteroscopica sono solo quelli sottomucosi […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":370,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-399","page","type-page","status-publish","hentry"],"yoast_head":"\nDr. Pulcinella Ruggero | Miomectomia Isteroscopica<\/title>\n<meta name=\"description\" content=\"Si presenta nel 20-50% delle donne ( specie in et\u00e0 perimenopausale), qui vengono descritti le sintomatologie.\" \/>\n<meta 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