{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:56:53Z","timestamp":1792166213600,"version":"4.4.0"},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to evaluate the effectiveness of hysteroscopic myomectomy in the symptoms of women with uterine myomatosis.  METHODS: This is a retrospective cohort study conducted on 119 women with uterine myomatosis who underwent hysteroscopic myomectomy in a tertiary hospital from 2018 to 2023. Women of reproductive age diagnosed with submucosal myoma who underwent hysteroscopic myomectomy were included, and women who did not have the data in their medical records necessary for completion were excluded. The sociodemographic and clinical variables of these women were evaluated.  RESULTS: The average age of the women was 41.4\u00b16.8 years. Among the fibroids, 37.0% were International Federation of Gynecology and Obstetrics (FIGO) 0 and 52.5% were FIGO 1. The average size of the fibroids was 2.7\u00b11.4 cm. There were 10.0% of complications. After myomectomy, 67.2% of the women had improvement in symptoms, 66.1% opted for hormonal treatment, and 14.3% underwent hysterectomy. Ninety percent of the women who did not show improvement in symptoms had FIGO 1 and FIGO 2 fibroids (p=0.002), and 57% had a higher number of cesarean sections (p=0.038). In addition, 61% of these women required a new approach (p&lt;0.001), and 93% opted for treatment after myomectomy (p&lt;0.001). Factors associated with a greater chance of women's symptoms not improving were having more than two cesarean sections (hazard ratio [HR]=3.52, p=0.026), FIGO 1 fibroids (HR=5.75, p=0.003), and FIGO 2\u20133 fibroids (HR=8.25, p=0.030).  CONCLUSION: Hysteroscopic myomectomy has a low complication rate, and having fibroids with a larger intramural component is the main factor responsible for myomectomy failure.<\/jats:p>","DOI":"10.1590\/1806-9282.20241525","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T07:05:11Z","timestamp":1748847911000},"source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of the effectiveness of hysteroscopic myomectomy in the symptoms of women with uterine myomatosis: a retrospective cohort"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7029-6365","authenticated-orcid":false,"given":"Alana","family":"Baptista Fim","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6198-5593","authenticated-orcid":false,"given":"Cristina Laguna","family":"Benetti-Pinto","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3889-4778","authenticated-orcid":false,"given":"Daniela Angerame","family":"Yela","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.13102","article-title":"Epidemiology and management of uterine fibroids","volume":"149","author":"Giuliani E","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1067\/mob.2003.99","article-title":"High cumulative incidence of uterine leiomyoma in black and white women: ultrasound 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(Lond)"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.3390\/medicina58111652","article-title":"Characteristics of submucous myomas and the risk of anemia","volume":"58","author":"Ricci G","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"3","key":"ref7","first-page":"225","article-title":"The impact of uterine leiomyomas on reproductive outcomes","volume":"62","author":"Cook H","year":"2010","journal-title":"Minerva Ginecol"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.3390\/medicina58111627","article-title":"Hysteroscopic myomectomy","volume":"58","author":"Lasmar RB","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ogc.2012.09.005","article-title":"The impact and management of fibroids for fertility: an evidence-based approach","volume":"39","author":"Guo XC","year":"2012","journal-title":"Obstet Gynecol Clin North Am"},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/humupd\/dmm041","article-title":"Hysteroscopic myomectomy: a comprehensive review of surgical techniques","volume":"14","author":"Spiezio Sardo A","year":"2008","journal-title":"Hum Reprod Update"},{"issue":"14","key":"ref11","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1056\/NEJMra1209993","article-title":"Uterine fibroids","volume":"369","author":"Bulun SE","year":"2013","journal-title":"N Engl J Med"},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/j.fertnstert.2011.01.147","article-title":"Feasibility of a new system of classification of submucous myomas: a multicenter study","volume":"95","author":"Lasmar RB","year":"2011","journal-title":"Fertil Steril"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ejogrb.2021.11.434","article-title":"Hysteroscopic myomectomy: the guidelines of the International Society for Gynecologic Endoscopy (ISGE)","volume":"268","author":"Loddo A","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"7","key":"ref14","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.bpobgyn.2015.03.009","article-title":"Complications of hysteroscopy and how to avoid them","volume":"29","author":"McGurgan PM","year":"2015","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/S0301-2115(02)00106-9","article-title":"A multicenter survey of complications associated with 21,676 operative hysteroscopies","volume":"104","author":"Aydeniz B","year":"2002","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"4","key":"ref16","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/GCO.0b013e3283630e10","article-title":"Surgical techniques and outcome in the management of submucous fibroids","volume":"25","author":"Capmas P","year":"2013","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"5","key":"ref17","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1590\/1806-9282.65.5.714","article-title":"Isthmocele: an overview of diagnosis and treatment","volume":"65","author":"Kremer TG","year":"2019","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"6","key":"ref18","article-title":"Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital","volume":"38","author":"Dias BAS","year":"2022","journal-title":"Cad Saude Publica"},{"issue":"4","key":"ref19","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.fertnstert.2022.06.031","article-title":"Cesarean scar defects and abnormal uterine bleeding: a systematic review and meta-analysis","volume":"118","author":"Murji A","year":"2022","journal-title":"Fertil Steril"}],"container-title":["Revista da Associa\u00e7\u00e3o 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