BioMed Research International / 2017 / Article / Tab 1

Review Article

Hysteroscopic Morcellation of Submucous Myomas: A Systematic Review

Table 1

Relevant data of retrieved studies.

Authors, yearType of studyEnrolled casesMean ageType of myomasType of HTRsMean operative time
(min)
Mean fluid deficit (mL)Main findings

Rubino and Lukes, 2015 [9]Randomized, prospective, comparative setting clinical trial42 myomas41.4 (overall, including also other pathologies)Type 0 or 1 myomas > 1.5 and <3.0 cmMyoSureNANA(1) 28 myomectomies were performed in office setting and 14 in ambulatory surgical center setting.
(2) The mean percentage of pathology removed was %.
(3) Both Uterine Fibroid Symptom-Quality of Life and Health-Related Quality of Life improved significantly 12 months after procedure.
(4) A fluid deficit of nearly 4 Lt was reported in at least one patient.

van Dongen et al., 2008 [10]Prospective randomized controlled study10 myomas49Type 0, type 1Truclear 8.010.6409The use of the HTRs reduced operating time more than 8 min in comparison to conventional resectoscopy.

Arnold et al., 2016 [11]Prospective cohort study102 myomas4329 type 0,
38 type 1,
17 type 2,
18 not documented
MyoSureNA88063 complete resection of pathology at the end of the procedure: 18 type 0, 27 type 1, and 11 type 2 myomas.

Lee and Matsuzono, 2016 [12]Retrospective study13 myomasNR2
patients with myoma protrusion < 60%, 11 patients > 60%; 9 small (≤3 cm) myomas, 4 large (>3 cm) myomas
MyoSure36.61005(1) No significant differences in overall patient satisfaction and improvement in hemoglobin level between intrauterine morcellation and resectoscopy at 3-month follow-up.
(2) HTRs significantly reduced operative time.

Rajesh and Guyer, 2015 [13]Retrospective study17 myomas58.6Type 0, type 1, and type 2; size 1–5 cmMyoSureNA495.3(1) All patients had successful removal of pathology apart from two partial myomectomies (calcified fibroids) and one failed MyoSure for patulous cervix.
(2) No complications occurred.
(3) Intrauterine morcellation is feasible also in outpatient setting.

Hamidouche et al., 2015 [14]Retrospective study34 myomas40.8Type 0, type 1, and type 2MyoSure30.8NANo significant differences for mean operative time, complete resection rate, adverse events, and postoperative adhesion between HTRs and bipolar loop resection.

Emanuel and
Wamsteker,
2005 [15]
Retrospective study28 myomas44.615 type 0,
13 type 1
Truclear 8.016.4660(1) Significant reduction of operative time for HTRs compared to resectoscopy.
(2) No complications.

Hamerlynck et al., 2011 [16]Retrospective study37 myomas45Type 0, type 1Truclear 8.018.2440(1) All procedures were uneventful.
(2) Implementation of the HTRs for removal of type 0 and 1 myomas ≤ 3 cm, and removal of polyps appears safe and effective.

HTRs: Hysteroscopic Tissue Removal systems; NA: not available.