Resectoscopic myomectomy.

OBJECTIVE: To evaluate safety and efficacy of resectoscopic myomectomy for control of menorrhagia, dysmenorrhea, and/or reproductive wastage.

DESIGN: Retrospective consecutive patient follow-up.

SETTING: Private practice, outpatient, hospital.

PATIENTS: All patients (92) having resectoscopic myomectomy between September 1, 1986 and December 31, 1989.

INTERVENTIONS: Resectoscopic myomectomy with or without concomitant procedures such as endometrial ablation.

MAIN OUTCOME MEASURES: Assessment of dysmenorrhea, menorrhagia, and reproductive outcome after surgery.

RESULTS: Elimination of dysmenorrhea in 24 of 28, absence of menorrhagia in 65 of 80, and pregnancy in 10 of 13 with two abortions in a total of 11 gestations. One patient was admitted and treated with one unit of autologous blood and mechanical tamponade with an intrauterine balloon. Three cases of uterine perforation had no sequelae. One patient had mild endometritis responding to outpatient antibiotics. Two cases of leiomyosarcoma were diagnosed histologically and accounted for two of the three hysterectomies noted during follow-up.

CONCLUSIONS: Resectoscopic myomectomy is a safe, effective, and relatively simple outpatient surgical procedure.