ABSTRACT
The submucous leiomyoma lies adjacent to and protruding into the uterine cavity. Because of its localization it can be approached by hysteroscopy, thereby reducing the burden for the patient compared with laparoscopy or laparotomy Submucous leiomyomata constitute an estimated 22% of all leiomyomata.1 However, the reliability of these data is questioned as the diagnosis is made by transvaginal ultrasound without using intracavitary saline or performing hysteroscopy. Symptoms of submucous leiomy omata may be abnormal vaginal blood loss (including menorrhagia), abdominal pain, fertil ity problems, and recurrent miscarriage. It has been said that submucous leiomyomata are more often symptomatic than the intramural or subserous ones.2 However, in a randomly selected sample of women aged 35-49 in the Washington DC area, no increased probability of menorrhagia was found in patients with sub mucous leiomyomata compared with patients having leiomyomata at other sites. The size of the leiomyoma, parity, and body mass index were indeed associated with menorrhagia.1 In premenopausal patients with abnormal uterine bleeding, submucous leiomyomata are reported at rates varying from 8% to 30%.3
