Hysteroscopic Myomectomy

A hysteroscopic myomectomy uses a long, slender scope, called a hysteroscope, to remove the fibroid. This procedure is only appropriate for women who have fibroids on the inner wall of the uterus (submucosal fibroids). These fibroids are the type most likely to cause uterine bleeding.

A local or general anesthetic may be used. The uterus is filled with fluid and the hysteroscope is inserted through the cervix into the uterus. This device guides the physician to the fibroid, which is then removed in pieces with a wire loop. Sometimes a second procedure is needed to remove the entire fibroid.

The greatest advantage of hysteroscopic myomectomy is the quick recovery time. It is usually done as day surgery, and a woman can resume her normal activities in a few days. After surgery, most women experience some pain and bleeding, but the pain can generally be managed with oral pain medication.

If your pain is severe or your bleeding is heavy and bright red, you should contact your doctor and return to the hospital emergency room immediately. The risks of this procedure include bleeding and infection, but these complications are rare.

Assuming that it is done correctly and there are no complications, a hysteroscopic myomectomy should not interfere with a woman’s fertility. Pregnancy rates have been high among women who had this procedure to remove a fibroid that was causing fertility problems.

Hysteroscopic Polypectomy

Uterine polyps are growths attached to inner wall of the uterus and protruding into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps. The sizes of uterine polyps range from a few millimeters — no larger than a sesame seed — to several centimeters — golf ball sized or larger. They are attached to the uterine wall by a large base or a thin stalk.

You can have one or many uterine polyps. They usually stay contained within your uterus, but occasionally, they may slip down through the opening of the uterus (cervix) into your vagina. Although they can happen earlier, uterine polyps most commonly occur in women in their 40s and 50s.