Modified sonohysterography immediately after hysteroscopy in the diagnosis of submucous myoma

Study Objective. To report a new, convenient, inexpensive, office-based examination to evaluate submucous myomas before hysteroscopic myomectomy. Design. Retrospective analysis (Canadian Task Force classification 11-2). Setting. University-affiliated teaching hospital. Patients. One hundred seventy-nine consecutive women. Intervention. Diagnostic flexible hysteroscopy and transvaginal ultrasonography. Measurements and Main Results. Transvaginal ultrasonography was performed immediately after hysteroscopy. The size and depth of invasion of submucous myomas were clearly identified by retained fluid after hysteroscopy. Locations of myomas were as follows: anterior wall, 37 (20.7%); posterior wall, 52 (29.1%); lateral wall, 40 (22.3%); and fundus, 31 (17.3%); and multiple myomas, 19 (10.6%). Myomas with stalk were found in 101 patients (56.4%) and without stalk in 78 (43.6%). The mean myoma diameter was 2.95 ± 2.12 cm and mean weight was 30.2 ± 33.6 g. Conclusion. It is important to obtain details as to size and depth of invasion of submucous myomas before hysteroscopic myomectomy. Sonohysterography immediately after hysteroscopy is superior to traditional diagnostic methods.