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Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old.

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Presentation on theme: "Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old."— Presentation transcript:

1 Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question  Paolo Casadio, M.D., Aly M. Youssef, M.D., Emanuela Spagnolo, M.D., Maria Antonietta Rizzo, M.D., Maria Rita Talamo, M.D., Denise De Angelis, M.D., Elena Marra, M.D., Tullio Ghi, M.D., Luca Savelli, M.D., Antonio Farina, M.D., Giuseppe Pelusi, Prof., Ivan Mazzon, M.D.  Fertility and Sterility  Volume 95, Issue 5, Pages e1 (April 2011) DOI: /j.fertnstert Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

2 Figure 1 Myometrial free margin evaluated before surgery. T0a, Myometrial free margin during TVS. T0b, Myometrial free margin evaluated during saline infusion sonography. Fertility and Sterility  , e1DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

3 Figure 2 Ultrasonographic myometrial free margin evaluation and hysteroscopic images corresponding to various operative phases. T1, Uterine cavity distension at the initial phase of operative hysteroscopy. T2, Slicing of intracavitary component of the fibroid. T3, Cold loop dissection of intramural component of the fibroid. T4, Slicing of the enucleated intramural component. Fertility and Sterility  , e1DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

4 Figure 3 Myometrial free margin (MFM) variation during preoperative evaluation and after the various intraoperative phases. Fertility and Sterility  , e1DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

5 Figure 4 Elastic centripetal forces (F) leading to dynamic changes in myometrial free margin. Fertility and Sterility  , e1DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions


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