Hysteroscopy pp 357-362 | Cite as

Limiting Factors of Office Hysteroscopic Myomectomy

  • Ricardo Bassil Lasmar
  • Bernardo Portugal Lasmar


The five limiting factors of office hysteroscopic myomectomy are related to the patient, the myoma, the technique, the technology, and the hysteroscopist. For the patient, her sensitivity to pain and discomfort to endure the procedure. The size, topography, and intracavitary portion of myoma are parameters that should be evaluated for decision of the procedure. The technique and technology are fundamental to enable the office procedure and, finally, as important as well, is the expertise of hysteroscopist, which is determinant to perform office hysteroscopic myomectomy.


Office procedure Hysteroscopic myomectomy Factors limiting 



The authors have no conflict interest.


  1. 1.
    Miller NF, Ludovici PP. On the origin and development of uterine fibroids. Am J Obstet Gynecol. 1955;70(4):720–40.CrossRefPubMedGoogle Scholar
  2. 2.
    Townsend DE, Sparkes RS, Baluda MC, McClelland G. Unicellular histogenesis of uterine leiomyomas as determined by electrophoresis by glucose-6-phosphate dehydrogenase. Am J Obstet Gynecol. 1970;107(8):1168–73.CrossRefPubMedGoogle Scholar
  3. 3.
    Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94:435–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90:967–73.CrossRefPubMedGoogle Scholar
  5. 5.
    Lasmar RB, Lasmar BP. The role of leiomyomas in the genesis of abnormal uterine bleeding (AUB). Best Pract Res Clin Obstet Gynaecol. 2016;pii:S1521-6934(16)30085-2.Google Scholar
  6. 6.
    Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: Results regarding degree of intramural extension. Obstet Gynecol. 1993;82:736–40.PubMedGoogle Scholar
  7. 7.
    Lasmar R, Barrozo P, Dias R, et al. Submucous myomas: a new presurgical classification to evaluate the viability of hysteroscopic surgical treatment—Preliminary report. J Minim Invas Gynecol. 2005;12:308–11.CrossRefGoogle Scholar
  8. 8.
    Neuwirth RS. A new technique and additional experience with hysteroscopic resection of submucous fibroids. Am J Obstet Gynecol. 1978;131:91–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Goldrath MH. Vaginal removal of the pedunculated submucous myomata. Historical observations and development of a new procedure. J Reprod Med. 1990;35:921–4.PubMedGoogle Scholar
  10. 10.
    Lasmar R, Barroso P. Histeroscopia – Uma abordagem prática, 1ª edição, Medsi, 2001.Google Scholar
  11. 11.
    Lasmar BP, Lasmar RB, Pillar C. Office hysteroscopic cervical myomectomy. Case report. Gynecol Surg. 2013;10:219–21.CrossRefGoogle Scholar
  12. 12.
    DI Spiezio SA, Ceci O, Zizolfi B, Nappi C, Bettocchi S. Office myomectomy. Minerva Ginecol. 2016;68(3):321–7.Google Scholar
  13. 13.
    Haimovich S, López-Yarto M, Urresta Ávila J, Saavedra Tascón A, Hernández JL, Carreras CR. Office hysteroscopic laser enucleation of submucous myomas without mass extraction: a case series study. Biomed Res Int. 2015;2015:905204.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Bettocchi S, Di-Spiezio-Sardo A, Ceci O, Nappi L, Guida M, Greco E, Pinto L, Camporiale AL, Nappi C. A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): a pilot study. J Minim Invasive Gynecol. 2009;16(6):748–54.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Ricardo Bassil Lasmar
    • 1
  • Bernardo Portugal Lasmar
    • 2
    • 3
  1. 1.Medicine Faculty, Department of SurgeryFederal Fluminense UniversityNiterói, Rio de JaneiroBrazil
  2. 2.Department of GynecologyEstacio de Sá University (UNESA)Rio de JaneiroBrazil
  3. 3.Department of Gynecological EndoscopyCentral Hospital Aristarcho Pessoa (HCAP-CBMERJ)Rio de JaneiroBrazil

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