Submucous myomas: A new presurgical classification to evaluate the viability of hysteroscopic surgical treatment—Preliminary report

Submucous Fibroid: Different Presurgical Classification Methods and Their Effect on Hysteroscopic Surgical Management

“…P value less than 0.05 is considered significant. (6) , but in this study, the maximum total score is 8 as the cases with penetration more than 50% of the fibroid into the myometrium were excluded ** (1+2+2+2+1) …”

“…With the objective of establishing a surgical prognosis and enabling a valid comparison of the results of the hysteroscopic myomectomy, it is essential to have a wide-ranging classification system that can correctly group together procedures of the same level of difficulty, however the classification system of the European Society of Endoscopic Surgery (ESES) considers only the degree of penetration of the submucous fibroid in the myometrium and so it was claimed to be inefficient at discriminating the complexity of hysteroscopic myomectomies (6) . In 2005 Lasmar et al developed a new classification for submucous myomas using five parameters: size, topography, extension of the base in relation to the uterine wall, and penetration into the myometrium and wall affected (STEPW).…”

“…According to this classification, a myomata type 0 is completely within the uterine cavity and appears only jointed to the cavity wall by a thin pedicle; a myomata type I is sessile myomata with less than 50% of the mass in the myometrium, or more than 50% in the uterine cavity ; and a myomata type II has more than 50% of the mass in the myometrium. Lasmar et., al ( 2005) proposed a new classification system that took into consideration not only the degree of penetration, but also other parameters including the extension of the base of the myoma with respect to the wall of the uterus, the size of the nodule (cm) by any of the imaging methods, the topography which is defined by the third of the uterine cavity where the myoma is situated and the wall of the uterus affected (STEPW classification) to evaluate the viability of hysteroscopic myomectomy in predicting partial or complete fibroid removal (6) . They reported that STEPW classification had a greater correlation with surgical outcomes as compared to ESES system.…”

Symptomatic submucous uterine fibroid: outcome of conservative surgery in a tertiary care hospital

“…If the score is above 7, hysteroscopic myomectomy is not indicated. 6 In present study 38 hysteroscopic myomectomies were undertaken. The patients' median age was 35 years (20 to 50).…”

Re: Sonographic predictors of surgery in fetal coarctation of the aorta. V. Jowett, P. Aparicio, S. Santhakumaran, A. Seale, H. Jicinska and H. M. Gardiner. Ultrasound Obstet Gynecol 2012; 40: 47–54.

“…This seems to fit the ultimate goal of achieving effective surgical outcomes whilst minimizing operative complications. The Lasmar score is based on degree of penetration of the myoma into the myometrium, distance of the base of the myoma from the uterine wall, size of the myoma, laterality of the myoma and topography of the uterine cavity 1 . However, it should be noted that in Lasmar's original work and our recently reported experience 2 , the outcome measures of most relevance in determining difficulty of hysteroscopic resection for skilled surgeons were myoma diameter and, depending on surgical technique, myoma grading.…”