Young Unmarried Girl With Multiple Myomas.Excessive Bleeding During Menses & even in Between the Menses was Her Major Complaint.

Few Important Points to be Noted.

1. Never give GnRH as small tiny fibroids will disappeare and reappear after 6/8 months.

2. Try to avoid using cuatery at the base to avoid damage to besal endometrium.

3. Try to resect thinner layer when you go closer to base of myoma bed.

4. Enucleation without energy source- cold knife technique should be used

5. Many a time, internal os will be open due to myomas protruding through cavity and maintaining distension is tricky. Also air bubbles need to be navigated which need experience

6. should not promise patient a single setting.

7. Avoid removing pieces from time to time as it will make field bloody and you will waste lot of fluid and time in clearing the field.

8. in this video you will notice all myomas were removed in one go.Never removed resectoscope.