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Hysteroscopic myomectomy

Linda D Bradley, MD
Section Editor
Tommaso Falcone, MD, FRCSC, FACOG
Deputy Editor
Sandy J Falk, MD, FACOG


Uterine leiomyomas (fibroids) are the most common pelvic tumor in women [1,2]. Abnormal uterine bleeding, the most common symptom associated with fibroids, is most frequent in women with tumors that abut the endometrium (lining of the uterine cavity), including submucosal and some intramural fibroids [3-5]. This is likely due to distortion of the uterine cavity and an increase in the bleeding surface of the endometrium [6]. Submucosal leiomyomas, which derive from myometrial cells just below the endometrium, account for approximately 15 to 20 percent of fibroids.

Historically, hysterotomy or hysterectomy was performed to remove submucosal leiomyomas. This has been largely replaced by hysteroscopic myomectomy, a minimally invasive surgical procedure that effectively and safely removes these lesions [4,7].

Hysteroscopic myomectomy is reviewed here. General principles of hysteroscopy and abdominal approaches to myomectomy are discussed separately. (See "Overview of hysteroscopy" and "Prolapsed uterine leiomyoma (fibroid)" and "Abdominal myomectomy".)


Hysteroscopic myomectomy is performed to remove intracavitary fibroids, a term that refers to (1) submucosal leiomyomas and (2) some intramural leiomyomas for which most of the fibroid protrudes into the uterine cavity. It is a minimally invasive procedure that is the procedure of choice for appropriate candidates. The ability to remove intracavitary fibroids depends upon surgical experience and skill.

Appropriate candidates for hysteroscopic myomectomy are women with the following characteristics:

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Literature review current through: Nov 2017. | This topic last updated: Sep 06, 2016.
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