Successful strategy for the hysteroscopic myomectomy of a submucous myoma arising from the uterine fundus

Objective: To introduce a technique for hysteroscopic resection of submucous myoma arising from the uterine fundus. Design: Case report. Setting: University hospital. Patient(s): A 43-year-old nulliparous Japanese woman. Intervention(s): An original combination technique of hysteroresectoscopy using circumferential myoma scraping, central vaporization, and intraoperative injection of prostaglandin F2α. Main Outcome Measure(s): Evaluation of clinical symptoms and imaging diagnosis. Result(s): Resection of a 40-mm fundal myoma was performed hysteroscopically, and the menorrhagia of the patient was remedied by the operation. Conclusion(s): Although large sessile fundal myomas are difficult to resect by hysteroscopic myomectomy, our original strategy may allow safe and certain surgery in such cases.