Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review

Scientific paper - Review paper

• Author: Andrea Etrusco
• Author: Antonio Laganà
• Author: Vito Chiantera
• Author: Amerigo Vitagliano
• Author: Ettore Cicinelli
• Author: Mislav Mikuš
• Author: Marina Šprem Goldštajn
• Author: Federico Ferrari
• Author: Stefano Uccella
• Author: Simone Garzon
• Author: Sandro Gerli
• Author: Alessandro Favilli
• Author's institution: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract (english)

The latest classification from the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) has reclassified type 3 myomas, changing their classification from intramural to submucosal. While hysteroscopic myomectomy is considered the gold standard treatment for patients experiencing symptoms from submucosal myomas, there are currently no specific guidelines available for managing type 3 myomas, and the optimal surgical approach remains uncertain.
Methods: The search for suitable articles published in English was carried out using the following databases (PROSPERO ID CRD42023418602): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Health Technology Assessment Database, Web of Science and search register. Only original studies reporting data on hysteroscopic myomectomy of type 3 myoma were considered eligible. The main outcomes investigated were the effectiveness and feasibility of hysteroscopic myomectomy and reproductive outcomes after surgical treatment.
Results: Two hundred and sixty-one studies were screened and nineteen of these were read for eligibility. Three studies encompassing 56 patients in total were included. Among the overall population studied, three patients needed an additional procedure to completely remove the myoma and five cases of post-surgical synechiae were recorded. No complications were reported. Of 42 patients wishing for pregnancy, the cumulative live birth rates before and after the hysteroscopic myomectomy were 14.3% and 42.9%, respectively.
Conclusions: Hysteroscopic myomectomy appears to be a safe and feasible approach. Nevertheless, data reported in the literature are extremely scarce and based on studies with few patients enrolled. New evidence is needed to assess the safety and effectiveness of hysteroscopic treatment for FIGO type 3 myomas.

• Keywords (english): female infertility; hysteroscopy; myoma type 3; myomectomy; uterine fibroids
• Language: english
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Journal of Clinical Medicine
• Numbering: vol. 12, no. 15, 4953
• e-ISSN: 2077-0383
• DOI: https://doi.org/10.3390/jcm12154953
• URN:NBN: urn:nbn:hr:105:734263
• Publication: 2023-07-27
• Document URL: https://www.mdpi.com/2077-0383/12/15/4953
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-09-02 08:14:59