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Here’s how hysteroscopic myomectomy works: Most women are familiar with dilatation and curettage (D&C), a procedure in which the cervical opening is made slightly larger in order to put an instrument into the uterine cavity to scrape away the lining of the uterus. It would be nice if a simple D&C could eliminate fibroids, but scraping the lining of the uterus to remove a fibroid is like raking leaves and expecting to remove the boulder in the ground. D&Cs are useful for evaluating bleeding, but are not really meant to treat the bleeding.
When I perform a D&C, it is always accompanied by hysteroscopy, in which I slide a slender scope with a camera and light attached to it through the cervix in order to see what’s going on inside the uterus. If a fibroid is present, I insert a small instrument through the hysteroscope to cut the fibroid into small pieces, a process known as fibroid resection or morcellation. The small pieces of fibroid than are easily removed. The patient goes home that day, fibroid-free.
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