{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:53:19Z","timestamp":1780066399339,"version":"3.54.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Hysteroscopic myomectomy is widely regarded as safe and feasible, although achieving single\u2010session results for larger myomas often requires alternative methods. This study introduces a novel approach: ultrasound\u2010guided myoma extirpation using ring forceps combined with hysteroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, single\u2010center study includes patients who underwent ultrasound\u2010guided myoma extirpation between 2016 and 2024. Data were collected retrospectively, and myomas were classified according to the International Federation of Gynecology and Obstetrics leiomyoma subclassification system. Under ultrasound guidance, the myoma was extirpated using ring forceps. The pre\u2010, peri\u2010, and postoperative outcomes were recorded and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 25 patients were included, with a mean age of 44.76\u2009\u00b1\u20098.09\u2009years. Most patients (92%) were premenopausal, and the primary symptoms were irregular bleeding (76%) and menorrhagia (68%). The median myoma size was 3\u2009cm (interquartile range [IQR]: 2\u20134\u2009cm). The median operation time was 30\u2009min (IQR: 20\u201342\u2009min). There was no statistically significant correlation between the duration of the operation and the diameter of the myoma uteri. Most myomas were located in the fundus, left side, or anterior wall (20% each), with 60% classified as type 0. Postoperative assessments revealed no residual myomas in 84% of cases. Uterine perforation and cervical laceration occurred as complications in two cases, while four cases required an additional session. Two patients with infertility achieved full\u2010term pregnancies post\u2010surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This new, minimally invasive technique might be a feasible option for large myomas, particularly in low\u2010resource settings. It minimizes the need for multiple sessions, providing reassuring results for patients with suitable indications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16179","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T12:25:27Z","timestamp":1737548727000},"page":"1217-1224","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An alternative for hysteroscopic myomectomy: Ultrasound\u2010guided single\u2010step myomectomy for submucous myoma uteri with ring forceps, a retrospective study"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5645-7064","authenticated-orcid":false,"given":"Ipek Betul","family":"Ozcivit Erkan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4497-7222","authenticated-orcid":false,"given":"Oguzhan","family":"Kuru","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkin","family":"Acar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atakan Mahmut","family":"Oztas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-7780","authenticated-orcid":false,"given":"Altay","family":"Gezer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1411029"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.07.030"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2011.09.005"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2021.03.001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.4274\/tjod.galenos.2020.64280"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.06.008"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/6848250"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2004.12.011"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2011.650656"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12666"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2217\/whe.15.89"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2012.12.002"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4274\/jtgga.2017.0135"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2005.01.018"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-003-0590-x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.07.714"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2508.1998.00203.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.04.002"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.105847"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15101"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15800"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14030327"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.11.434"}],"container-title":["International Journal of Gynecology &amp; 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