Postoperative evaluation of the uterus after hysteroscopic versus Laparoscopic myomectomy of type 1 and type 2 submucous myomas

Abstract BackgroundMyomectomy of submucous fibroids is usually performed using hysteroscopic approach. The reproductive performance of women after removal of submucous myomas is much better in type 0 more than type 1 and 2. This conflict result might be due to harmful effect of hysteroscopy on the endometrium and inadequate healing. The objective of the cohort study was to evaluate the uterus after myomectomy using 2 surgical approaches. Both hysteroscopic and laparoscopic myomectomy were used. Methods: A total of 74 patients with submucous fibroids were recruited and were randomly divided equally into 2 groups. Group (1) included those in whom laparoscopic myomectomy was done while in group (2) the hysteroscopic myomectomy was used. The hysteroscopic myomectomy was done using the standard techniques using the resectoscope with wire loop. The laparoscopic method was also done using the standard techniques. Results: The duration of surgery was longer in group one and significant decrease in hemoglobin level in group one. Postoperative hysteroscopic evaluation of the uterus showed better endometrial thickness, interface and normal myometrium denoting normal uterine cavity in group (one) when compared with group (two). The complication rate was comparable in both groups. Conclusion: Surgical treatment of type 1 and 2 submucous fibroid is feasible by both hysteroscopic and laparoscopic approaches. The laparoscopic approach had better postoperative endometrium and myometrium, fewer days of postoperative uterine bleeding and better functioning endometrium.