Comment on: “Should the myometrial free margin still be considered a limiting factor for hysteroscopic resection of submucous fibroids? A possible answer to an old question.”

24 10 2011

To the Editor:

Paolo Casadio et al. recently published an interesting paper focusing on the dynamic changes of the myometrial free margin separating type II submucous fibroids from the serosa during hysteroscopic resection (1). Although the number of patients of this prospective observational study is limited (n = 13), the authors interestingly concluded that “myometrial free margin increases progressively with each step of the procedure probably leading to an increasing margin of safety.” This study updates and reinforces the previous observation by Yang et al., which first demonstrated that the myometrial free margin is not a static parameter but it “increased gradually after each step of the resection, reaching its maximum after the completion of the procedure” (2). They observed the progressive thickening of myometrium at transabdominal sonography while the myoma is progressively enucleated, suggesting two possible mechanism for this phenomenon: the reshaping of the distended uterine myometrial fibers and the contractions induced by electrosurgery and the myoma grasping by forceps. Read the rest of this entry »

Does uterine artery ligation, performed because of a severe postpartum hemorrhage, alter fertility?

26 04 2011

To the Editor:

We read with interest the case series report by Blanc et al. that highlights the risk of synechia after uterine-sparing procedures (1). The authors concluded that their “results suggest that triple ligation (TUAL), with or without haemostatic multiple square suturing (HMSS), exposes patients to the risk of subsequent abnormalities of the uterine cavity.” (1).

Regarding HMSS, we could not agree more with the authors, as we have been attempting to alert physicians to the possible hidden mid-term or long-term effects of uterine compression sutures (2–6), although these procedures were adopted promptly throughout the world. Read the rest of this entry »

Comment on “Body mass index is an independent risk factor for the development of endometrial polyps in patients undergoing in vitro fertilization.”

4 03 2009

To the Editor:

We would like to make some comments on the paper by Onalan et al (1). In this paper, the authors found that obesity could be a factor in initiating the growth of an endometrial polyp because they identified obesity as the only independent risk factor using logistic regression analysis. Read the rest of this entry »