{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:40:53Z","timestamp":1770752453886,"version":"3.50.0"},"reference-count":4,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"published-print":{"date-parts":[[2003]]},"abstract":"<jats:p>&lt;i&gt;Objective:&lt;\/i&gt; To compare the efficacy, feasibility, operative time and possible complications of a modified technique of hysteroscopic removal of large submucus myomata versus traditional morcellation technique, and to assess the efficacy of preoperative sonohysterography (SHG). &lt;i&gt;Design:&lt;\/i&gt; A prospective comparative study. &lt;i&gt;Setting:&lt;\/i&gt; Gynecologic Endoscopy Unit, Assiut University Hospital, Assiut, Egypt. &lt;i&gt;Subjects:&lt;\/i&gt; One hundred forty-two women of childbearing age with a clinical and transvaginal sonographic diagnosis of large solitary submucous myomata (&gt;3 cm in diameter) with or without an intramural element. &lt;i&gt;Interventions:&lt;\/i&gt; The patients were divided into two groups. In group A (65 patients), a modified resectoscopic technique was used where the base of the myoma was excised followed by ring forceps extraction after misoprostol priming. In group B (77 patients), the myoma was cut using traditional resectoscopic morcellation. &lt;i&gt;Main Outcome Measures:&lt;\/i&gt; For each patient, operating time, intra- and postoperative complications and feasibility of the procedure were recorded. The accuracy of preoperative SHG in localizing submucous myoma and detecting intramural extension was assessed by diagnostic hysteroscopy. &lt;i&gt;Results:&lt;\/i&gt; Transvaginal SHG showed good agreement with hysteroscopy in localizing submucous myomata and detecting intramural extension (k = 0.83). The operating time was significantly shorter in group A (15.6 \u00b1 3.02 min) than in group B (28.9 \u00b1 4.3 min). The procedure was completed in 60 (92%) and 51 patients (66%), whereas a second session was required in 2 (3%) and 20 patients (25.9%) in both groups respectively. Glycine volume was highly significantly less in group A (2.3 \u00b1 0.86 vs. 6.3\u00b1 1.7 liters, p = 0.001). Intraoperative complications were encountered in 9 (13.8%) and 22 patients (28.5%) in both groups respectively (p = 0.03). Cervical laceration was diagnosed in 3 cases (4.6%) in group A. Postoperative visual disturbances were diagnosed in 4 cases (5%) in group B. &lt;i&gt;Conclusions:&lt;\/i&gt; Hysteroscopic resection of large submucous myomata with minimal intramural encroachment is feasible using a modified technique. It shows a minimal complication rate and fluid deficit and a shorter operative time than the standard morcellation technique. If the excised myoma is extracted as one mass, this carries a minimal risk of cervical lacerations and possible cervical incompetence in a subsequent pregnancy. Transvaginal SHG is a reliable diagnostic aid to assess submucous myomata.<\/jats:p>","DOI":"10.1159\/000074451","type":"journal-article","created":{"date-parts":[[2003,10,24]],"date-time":"2003-10-24T08:54:20Z","timestamp":1066985660000},"page":"192-196","source":"Crossref","is-referenced-by-count":18,"title":["Modified Hysteroscopic Myomectomy of Large Submucous Fibroids"],"prefix":"10.1159","volume":"56","author":[{"given":"Atef","family":"Darwish","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2003,12,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(01)00485-7"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1159\/000010132"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-3944(00)00458-2"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)01063-2"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/74451","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/74451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:53:02Z","timestamp":1745466782000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000074451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003]]},"references-count":4,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2003,12,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000074451","archive":["Portico"],"relation":{},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"value":"0378-7346","type":"print"},{"value":"1423-002X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003]]}}}