Endoloop ligation technique for prolapsed pedunculated submucous uterine myoma: utility and reliability

Purpose We use a non-surgical endoloop snare technique to remove prolapsed pedunculated submucous uterine myomas under the concept that ligating the pedicle causes tumor necrosis and natural elimination of the tumor. We evaluated our method on the basis of clinical outcomes.

For pertinent clinical data, we reviewed the hospital records of 11 patients treated by our new method between July 2009 and 2010 and followed up for 22–31 months.

Patients’ mean age was 40.9 years, and the mean hemoglobin level was 10.6 g/dl. None required urgent hospitalization, blood transfusion, or laparotomy. The tumors were eliminated naturally or removed by cutting necrotic pedicle within 4–11 days. One patient required a second endoloop application. Another one patient required follow-up surgery for a second submucous myoma, adenomyosis, and persistent hypermenorrhea.

Endoloop ligation is feasible for eliminating prolapsed pedunculated submucous myoma. It is simple and safe and can be performed in the outpatient setting. Similar content being viewed by others

Buttram VC, Reiter RC (1981) Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 36:4433–4445 Van der Kooij SM, Hehenkamp WJK, Volkers NA, Birnie E, Ankum WM, Reekers JA (2010) Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial. Am J Obstet Gynecol 203:105.e1–105.e13 Wamsteker K, Emanuel MH, de Kruif JH (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 82:736–740 Cravello L, Stolla V, Bretelle F, Roger V, Blanc B (2000) Hysteroscopic resection of endometrial polyps: a study of 195 cases. Eur J Obstet Gynecol Reprod Biol 93:131–134 Ben-Baruch G, Schiff E, Menashe Y, Menczer J (1988) Immediate and late outcome of vaginal myomectomy for prolapsed pedunculated submucous myoma. Obstet Gynecol 72:858–861 Dicker D, Feldberg D, Dekel A, Yeshaya A, Samuel N, Goldman JA (1986) The management of prolapsed pedunculated submucous fibroids. Aust NZ J Obstet Gynaecol 26:308–311 Golan A, Zachalka N, Lurie S, Sagiv R, Glezerman M (2005) Vaginal removal of prolapsed pedunculated submucous myoma: a short, simple, and definitive procedure with minimal morbidity. Arch Gynecol Obstet 271:11–13 Caglar GS, Tasci Y, Kayikcioglu F (2005) Management of prolapsed pedunculated myomas. Int J Gynaecol Obste 89:146–147 Vilos GA, Alshimmiri MM (1995) Cost-benefit analysis of laparoscopic versus laparotomy salpingo-oophorectomy for benign tubo-ovarian disease. J Am Assoc Gynecol Laparos 2:299–303 Lim YH, Ng SP, Ng PH, Tan AE, Jamil MA (2007) Laparoscopic salpingectomy in tubal pregnancy: prospective randomized trial using endoloop versus electrocautery. J Obstet Gynaecol Res 33:855–862 Song J, Cho SJ, Park CS, Kim SH, Ku PS, Lee MA (1998) Two uterine arterial management methods in laparoscopic hysterectomy. J Obstet Gynaecol Res 24:145–151 Chien JC, Hsieh SC, Lee RC, Chen CY, Cheng CJ, Chan WP (2005) Endometrial stromal sarcoma mimicking submucosal myoma protruding to the vagina: mRI findings. Eur J Gynaecol Oncol 26:657–660 Conflict of interest None. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Ujihira, T., Ota, T., Nagano, H. et al. Endoloop ligation technique for prolapsed pedunculated submucous uterine myoma: utility and reliability. Arch Gynecol Obstet 287, 697–701 (2013). https://doi.org/10.1007/s00404-012-2610-1 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-012-2610-1