الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The most frequent solid tumor in the female pelvis is the uterine myoma appearing in 20% to 40% of women older than 30 years and today it is the main cause for hysterectomy (67% of the indications in the USA). A high frequency of symptoms, such as bleeding, pain, or reproductive problems, is caused by submucous myomas (5% to 10 %). Until the introduction of the hysteroscopic technique, therapeutic and diagnostic management was limited.
The most common symptom that motivates patients to seek medical attention is abnormal uterine bleeding. Also it is the most common cause for intervention. Reproductive problems are the second leading indication for hysteroscopic myomectomy. Less frequently, dysmenorrhea or nonspecific pelvic pain may justify hysteroscopic myomectomy.
The most important part in hysteroscopic myomectomy is deciding when to stop the resection to avoid excessive damage to the myometrium and immediate complications i.e., perforation or more delayed complications i.e., postoperative synechiae or uterine rupture in subsequent pregnancies, and not to leave residual myoma which need second intervention.
This study was designed to prospectively evaluate the efficacy and safety of trans-abdominal ultrasound guidance in hysteroscopic resection submucous myoma On thirty women with grade I submucous myoma.
So we did our study on 60 patients , 30 patients underwent resection under transabdominal ultrasound guidance to precise complete resection of submucous myoma without any residual and without compilications which was our main aim and the other 30 has resection without ultrasound guidance to serve as control.
The patients were divided at random into two groups:
Group (A): (30 patients) where hysteroscopic resection of submucous myoma grade I was done in follicular phase of cycle under ultrasound guidance.
Group (B): (30 patients) where hysteroscopic resection of submucous myoma grade I was done in follicular phase of cycle without ultrasound guidance
The result of the study were tabulated and statistically analyzed and revealed: No statically difference in both group A, B as regard age, gravidity , parity, medical and surgical history, complain, location of myoma or postoperative size.
We found in our study preoperative submucous myoma size for group (A) was statically larger than group (B), while no statically difference in both groups as regard to posoperative residual myoma size .
The finding in this study is when comparing the effectiveness of an ultrasound guided hysteroscopic myomectomy in one-step resection of submucous myoma it was found that intraoperative use of US offers no additional benefits in patients with submucosal myomas who have traditionally qualified for hysteroscopic myomectomy but