Technique of vaginal myomectomy for intracavitary submucous myomas

BACKGROUND: Myomectomy for submucous leiomyomas can be accomplished by open, laparoscopic, hysteroscopic, and vaginal approaches. An additional useful vaginal approach is described. CASES: Three cases of successful vaginal removal of intracavitary submucous myomas are presented. The myomas in all 3 cases were removed by a technique involving a single longitudinal posterior cervical incision. Indications included brisk vaginal bleeding, large relative myoma size, and difficult pedicle identification. In 2 of the 3 cases, the peritoneal cavity was entered, and in one case, hysteroscopy was used. Blood loss and postoperative complications were minimal with quick postoperative recovery. CONCLUSION: Vaginal myomectomy through a single longitudinal posterior cervical incision is a simple, quick alternative to traditional methods in selected patients.