Uterine leiomyomas

Uterine leiomyomas are frequent, have an impact on reproductive function and on women quality of life. They are classified according to their location in the uterus, and submucosal fibroids would be most related to the uterine bleeding. When they are symptomatic, should be removed by surgery and the approach for myomectomy depends on their classification.

In 1978, Neuwirth held the first hysteroscopic myomectomy using urological resectoscope with applying surgical technique similar to the resection of the prostate, with a resectoscope and “U” loop, slicing the fibroid and, sometimes, damaging the adjacent myometrium. The slicing technique fibroid, gold standard technique, leads to severe exposure lump vessels, causing greater blood loss, through strain absorption and sometimes myometrium damage with consequences for reproduction. Some authors already make hysteroscopic myomectomy using the pseudocapsule. Litta et al, make the release after the resection of the intracavitary portion of the myoma, while Mazzon releases the intramural portion of
the fibroid with cold loop. The uterine myoma pseudocapsule is a fibrous structure surrounding the neurovascular leiomyoma, separating it from the normal peripheral myometrium.

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