Hysteroscopic Myomectomy of Large submucous Myoma in a 1-Step Procedure Using Prostaglandin f2 alpha

Objective: To assesses the efficacy of prostaglandin f2 alpha in hystroscopic myomectomy of submucousal myomas.Design: Randomized clinical trial studySetting: A university teaching hospital of Iran University of medical center, Tehran, Iran.Patients: Forty four patients with symptomatic submucous myomas were randomly assigned in two groups. Twenty two patients in each group.Interventions: In PG group, prostaglandin f2 alpha was injected two times. The first intra-cervical injection of prostaglandin f2 alpha (PGf2α) was done before starting the surgery and the second intra-cervical injection of PGf2α was done, after resection of intrauterine portion of submucous myoma by slicing technique. Then the procedure continued until complete removal of the remnant intramural node which squeezed into the uterine cavity by uterine contractions induced after PGf2α injection. The same procedure was performed in control group without PG injection.Measurements and Main Results: There were no differences in baseline characteristics of patients of the two groups like demographic characteristics, myomas size and type. The rate of complete removal of submucous myomas in PG group was 87% and in control group was 65.2 %( p value 0/1). The rate of 1-step complete removal of large submucous myomas (> 5cm) in PG group was significantly more than control group (80% vs. 25%) (p= 0.03).The mean duration of both surgery and bleeding days after surgery in control group was less than PG group (p=0.01). There were no differences between duration of hospital stay and level of Hb drop in control group and PG group (p=0.07).Conclusions: Using prostaglandin f2 alpha is a useful intervention for a 1-step complete resection of large submucous myomas in hysteroscopic myomectomy.