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Clinical Reproductive Medicine and Surgery pp 345–370Cite as

Hysteroscopic Management of Intrauterine Disorders: Polypectomy, Myomectomy, Endometrial Ablation, Adhesiolysis, and Removal of Uterine Septum

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Abstract

Hysteroscopy is a minimally invasive and highly accurate means of diagnosing and treating a multitude of intrauterine pathology. It has become an indispensable tool for treating fibroids, polyps, synechiae, and congenital uterine anomalies and for performing endometrial ablation procedures. Specific classification systems exist for fibroids, synechiae, and congenital anomalies, which allow the pathology to be categorized into surgically meaningful groups that guide the approach for resection. Specific techniques are also required to treat each condition. The correct equipment must be used to ensure the optimal outcome, and the resection of these lesions should be carried out in a systematic manner. Clinicians should also be cognizant of complications they may encounter before performing these procedures so that greater care may be taken to avoid them.

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Abbreviations

Office hysteroscopy and vaginoscopy:

Hysteroscopic procedures that are commonly performed in an office setting without the need for local or regional anesthesia. This includes diagnostic hysteroscopy, polypectomy, lysis of adhesions, metroplasty, and small myomectomy

Operative hysteroscopy:

These are hysteroscopic procedures that require regional or general anesthesia and include endometrial removal of large polyps and myomas. These procedures often utilize energy sources such as mono and bipolar energy intrauterine shavers (morcellators)

Intrauterine polypectomy:

∎

Submucous myomectomy:

Including the removal of type 0, I, II, and III myomas, Asherman’s syndrome—The presence of intrauterine scar tissue

Uterine metroplasty—Uterine septum repair:

∎

Resectoscopy:

The use of a monopolar or bipolar resectoscope

Intrauterine shaving (morcellation):

∎

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Authors and Affiliations

  1. Minimally Invasive Gynecologic Surgery Unit, Newton Wellesley Hospital, 2014 Washington Street, 2nd Floor, MIGS Unit, Newton, MA, 02462, USA

    Michelle G. Park MD

  2. Newton Wellesley Hospital, Harvard Medical School, Newton, MA, USA

    Keith B. Isaacson MD

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  1. Michelle G. Park MD
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Correspondence to Michelle G. Park MD .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA

    Tommaso Falcone

  2. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA

    William W. Hurd

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Park, M.G., Isaacson, K.B. (2017). Hysteroscopic Management of Intrauterine Disorders: Polypectomy, Myomectomy, Endometrial Ablation, Adhesiolysis, and Removal of Uterine Septum. In: Falcone, T., Hurd, W. (eds) Clinical Reproductive Medicine and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-52210-4_20

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  • DOI: https://doi.org/10.1007/978-3-319-52210-4_20

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