Hysteroscopic myomectomy: Recurrence and satisfaction survey at short- and long-term

Objectives. - To assess the postoperative results at short- and long-term after hysteroscopic resection of submucosal myoma giving rise to symptoms. Patients and methods. - Retrospective study (University Hospital Estaing, Clermont-Ferrand, France) including patients operated by hysteroscopy in 2004 for one or more submucosal myomas giving rise to symptoms. A survey concerning relapse of symptoms and patient satisfaction was made by phone 4 and 6 years after surgery. Results. - Seventy-two patients (mean age: 45.6 years [18-70]) underwent hysteroscopy. At the time of the first survey, the rate of recurrence was 22% (n = 15) with 87.5% of cases of recurrence in the first year. Nineteen percent of the patients needed subsequent treatment. The significant factors for the risk of failure of treatment included younger age, number and large size myoma, intramural extension and incomplete resection. In 2010, the overall failure rate was 31.7% (n = 20). Fifty percent of the patients who had an incomplete resection required no further treatment. Conclusion. - In 70% of cases, hysteroscopic resection remains efficient at long-term. Repeat surgery should not be systematic after incomplete resection. The patients must be fully informed, and especially with respect to the risk factors for recurrence. (C) 2011 Elsevier Masson SAS. All rights reserved.