To assess the efficacy of prostaglandin F 2 alpha (PGF) in hysteroscopic myomectomy of submucous myomas.
A single-blind, randomized clinical trial study.
A teaching hospital, affiliate of Iran University of Medical Sciences, Tehran, Iran.
Forty-four patients with symptomatic submucous myomas were randomly assigned to the intervention group (n=21; 1 excluded owing to myoma not identified on pathology) and the control group (n=22).
In the intervention group, PGF was injected into the cervix twice: before the beginning of surgery and after resection of the intrauterine portion of the submucous myoma. The procedure was continued until complete removal of the remnant intramural node contracted into the uterine cavity from induction following PGF administration. The same procedure was performed in the control group without PGF injection.
There was no difference in demographics, size, or type of myomas between groups at baseline. Although complete removal of submucous myomas in the intervention group (PGF) was higher (20/23 myomas or 87%) than the control group (15/23 myomas or 65.2%), the difference was not significant (P=0.1). The number of 1-step complete removal of large submucous myomas (>5 cm) in the PGF group was significantly higher compared to the control group (8/10 myomas [80%] vs. 2/8 myomas [25%], p= 0.03). Mean duration of operative time was significantly longer in the intervention group than the control group (p=0.01). The intervention group experienced more days of postoperative bleeding than the control group (p=0.001). There were no differences between groups regarding hospital length of stay or hemoglobin levels (p=0.07).
In the current study, injection of PGF was beneficial for 1-step complete resection of large (> 5 cm) submucous myomas via hysteroscopic myomectomy.

Copyright © 2020. Published by Elsevier Inc.