Hysteroscopic treatment of symptomatic submucous fibroids using a bipolar intrauterine system: A feasibility study

Thirty-seven women with symptomatic submucous fibroids were identified on outpatient hysteroscopy. All underwent hysteroscopic excision or ablation using a bipolar intrauterine system (Versapoint(TM)). The main outcomes measures were change in uterine bleeding symptoms and use of health service resources at 6 months following treatment. 36/37 (97%) women returned completed outcome questionnaires. The mean amount of abnormal uterine bleeding was reduced at 6 months compared to immediately prior to treatment (P=0.0001). Improvement in bleeding symptoms was reported by 28/36 (78%) women and satisfaction with treatment by 33/36 (92%) women. All procedures were successfully completed, there were no serious operative complications. The mean cost of diagnosis and treatment of submucous fibroids using an endoscopic bipolar intrauterine system was 40% cheaper at 6 months follow up than a hysterectomy or open myomectomy (pound1266 versus pound2123). Hysteroscopic treatment of symptomatic submucous fibroids appears to be safe, efficacious and cost effective.