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BioMed Research International
Volume 2017 (2017), Article ID 6848250, 6 pages
https://doi.org/10.1155/2017/6848250
Review Article

Hysteroscopic Morcellation of Submucous Myomas: A Systematic Review

1Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
2Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
3Department of Obstetrics and Gynecology, University of Naples “Federico II”, Naples, Italy
4Department of Maternal and Child Health, Gavardo Hospital, Brescia, Italy
5Unit of Psychodiagnostics and Clinical Psychology, University of Catania, Catania, Italy
6Department of Woman and Child Health, University of Padua, Padua, Italy

Correspondence should be addressed to Salvatore Giovanni Vitale; moc.liamtoh@erotavlaselativ

Received 10 February 2017; Revised 22 May 2017; Accepted 1 August 2017; Published 29 August 2017

Academic Editor: Markus Wallwiener

Copyright © 2017 Salvatore Giovanni Vitale et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hysteroscopic surgery is the actual gold standard treatment for several types of intrauterine pathologies, including submucous myomas (SMs). To date, the availability of Hysteroscopic Tissue Removal systems (HTRs) opened a new scenario. Based on these elements, the aim of this article is to review the available evidence about HTRs for the management of SMs. We included 8 papers (3 prospective studies and 5 retrospective studies). A total of 283 women underwent intrauterine morcellation of SM: 208 were treated using MyoSure and 75 using Truclear 8.0. Only 3 articles reported data about procedures performed in outpatient/office setting. Only half of the included studies included type 2 SMs. HTRs significantly reduced operative time compared to traditional resectoscopy in some studies, whereas others did not find significant differences. Despite the availability of few randomized controlled trials and the cost of the instrument, according to our systematic review, the use of HTRs seems to be a feasible surgical option in terms of operative time and complications. Nevertheless, the type of SM still remains the biggest challenge: type 0 and 1 SMs are easier to manage with respect to type 2, reflecting what already is known for the “classic” hysteroscopic myomectomy.