Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity
Background: Submucosal myoma is a common gynecological disease that causes menorrhagia and infertility. While hysteroscopic surgery is a minimally invasive and effective method for treating submucosal myomas, its feasibility depends on the size and location of the myomas. Conversely, abdominal proce...
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| Format: | Article |
| Language: | English |
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IMR Press
2022-07-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/49/8/10.31083/j.ceog4908172 |
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| author | Kazuki Saito Tomonori Ishikawa Moeko Onose Rinko Ibi Kenichi Tatsumi Naoyuki Miyasaka |
| author_facet | Kazuki Saito Tomonori Ishikawa Moeko Onose Rinko Ibi Kenichi Tatsumi Naoyuki Miyasaka |
| author_sort | Kazuki Saito |
| collection | DOAJ |
| description | Background: Submucosal myoma is a common gynecological disease that causes menorrhagia and infertility. While hysteroscopic surgery is a minimally invasive and effective method for treating submucosal myomas, its feasibility depends on the size and location of the myomas. Conversely, abdominal procedures enable enucleation of submucosal myomas and preservation of endometrial integrity, but are accompanied by technical difficulties. Herein we report the case of an infertile woman with a submucosal and an intramural myoma who underwent laparoscopic myomectomy using laparoscopic ultrasonography. Case: The patient was a 36-year-old infertile woman. Transvaginal ultrasonography revealed a 15 mm submucosal myoma with a 60% myometrial extension in the anterior uterine wall and a 49 mm intramural myoma in the posterior wall. During myomectomy, the submucosal myoma was not apparent from the external side of the uterus; therefore, laparoscopic ultrasonography was used to detect it. Under ultrasonography, vasopressin was injected between the myoma and the myometrium, thereby separating the layers. Consequently, we were able to resect both myomas without breaching the endometrium. Conclusions: The present case demonstrates the effectiveness of laparoscopic ultrasonography for detecting submucosal myomas and ensuring injection of vasopressin into the proper layer. These advantages allow surgeons to preserve endometrial integrity during laparoscopic myomectomy. |
| format | Article |
| id | doaj-art-6f7638b676ca418088fda6a8a6675bc6 |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-6f7638b676ca418088fda6a8a6675bc62025-08-20T03:52:28ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-07-0149817210.31083/j.ceog4908172S0390-6663(22)01860-7Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrityKazuki Saito0Tomonori Ishikawa1Moeko Onose2Rinko Ibi3Kenichi Tatsumi4Naoyuki Miyasaka5Department of Perinatal and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 113-8510 Tokyo, JapanDepartment of Perinatal and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 113-8510 Tokyo, JapanDepartment of Comprehensive Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, 113-8510 Tokyo, JapanDepartment of Comprehensive Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, 113-8510 Tokyo, JapanUmegaoka Women's Clinic, Umegaoka, Setagaya, 154-0022 Tokyo, JapanDepartment of Comprehensive Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, 113-8510 Tokyo, JapanBackground: Submucosal myoma is a common gynecological disease that causes menorrhagia and infertility. While hysteroscopic surgery is a minimally invasive and effective method for treating submucosal myomas, its feasibility depends on the size and location of the myomas. Conversely, abdominal procedures enable enucleation of submucosal myomas and preservation of endometrial integrity, but are accompanied by technical difficulties. Herein we report the case of an infertile woman with a submucosal and an intramural myoma who underwent laparoscopic myomectomy using laparoscopic ultrasonography. Case: The patient was a 36-year-old infertile woman. Transvaginal ultrasonography revealed a 15 mm submucosal myoma with a 60% myometrial extension in the anterior uterine wall and a 49 mm intramural myoma in the posterior wall. During myomectomy, the submucosal myoma was not apparent from the external side of the uterus; therefore, laparoscopic ultrasonography was used to detect it. Under ultrasonography, vasopressin was injected between the myoma and the myometrium, thereby separating the layers. Consequently, we were able to resect both myomas without breaching the endometrium. Conclusions: The present case demonstrates the effectiveness of laparoscopic ultrasonography for detecting submucosal myomas and ensuring injection of vasopressin into the proper layer. These advantages allow surgeons to preserve endometrial integrity during laparoscopic myomectomy.https://www.imrpress.com/journal/CEOG/49/8/10.31083/j.ceog4908172endometriumlaparoscopic myomectomylaparoscopic ultrasonographysubmucosal myoma |
| spellingShingle | Kazuki Saito Tomonori Ishikawa Moeko Onose Rinko Ibi Kenichi Tatsumi Naoyuki Miyasaka Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity Clinical and Experimental Obstetrics & Gynecology endometrium laparoscopic myomectomy laparoscopic ultrasonography submucosal myoma |
| title | Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity |
| title_full | Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity |
| title_fullStr | Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity |
| title_full_unstemmed | Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity |
| title_short | Laparoscopic ultrasonography-guided myomectomy of submucosal myoma for preserving endometrial integrity |
| title_sort | laparoscopic ultrasonography guided myomectomy of submucosal myoma for preserving endometrial integrity |
| topic | endometrium laparoscopic myomectomy laparoscopic ultrasonography submucosal myoma |
| url | https://www.imrpress.com/journal/CEOG/49/8/10.31083/j.ceog4908172 |
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