Is Cold Loop Hysteroscopic Myomectomy a Safe and Effective Technique for the Treatment of Submucous Myomas With Intramural Development? A Series of 1434 Surgical Procedures

Study Objective: To assess the safety and efficacy of cold loop hysteroscopic myomectomy in a large series of cases. Design: Retrospective study (Canadian Task Force Classification III). Setting: Arbor Vitae Center for Endoscopic Gynecology, Rome, Italy. Patients: A total of 1215 patients with 1 or more GI-G2 submucous myomas. Intervention: Cold loop hysteroscopic myomectomy. Measurement and Main Results: A total of 1690 myomas were removed. A minimum of 1 to a maximum of 5 fibroids for each surgical procedure were totally removed. Out of 1215 patients, 1017 (83.7%) were treated with a single surgical procedure. Twelve intraoperative complications occurred (0.84%). No cases of uterine perforation with the thermal loop or clinical intravasation syndrome were reported. Conclusion: Cold loop hysteroscopic myomectomy seems to represent a safe and effective procedure for the removal of sub mucous myomas with intramural development, while at the same time respecting the anatomic and functional integrity of the myometrium. The use of a cold loop in resectoscopic myomectomy is associated with a low rate of minor intraoperative complications and an absence of major complications. This could be of primary relevance with a view to fertility and future pregnancies.