MyoSure: A Minimally Invasive Hysteroscopic Tissue Removal System
MyoSure is a hysteroscopic morcellation device designed for minimally invasive removal of intrauterine pathologies such as polyps and fibroids, offering faster procedure times and higher complete removal rates compared to conventional resectoscopy.
Device Description and Mechanism
MyoSure is a mechanical hysteroscopic tissue removal system that works by:
- Operating through a hysteroscope under direct visualization
- Using a rotating blade to cut and simultaneously remove tissue fragments
- Providing continuous real-time tissue fragment removal through suction
- Allowing for preservation of the uterus while treating intrauterine pathologies
Clinical Applications
MyoSure is primarily indicated for:
- Removal of endometrial polyps
- Removal of submucosal fibroids (particularly type 0 and type I)
- Management of retained products of conception
- Treatment of intrauterine pathologies causing abnormal uterine bleeding
Efficacy and Performance
Research demonstrates significant advantages of MyoSure over conventional techniques:
- Higher success rates for complete pathology removal (95.4% overall removal rate, with 99.3% for polyps and 86.8% for fibroids) 1
- Shorter operation times compared to conventional resectoscopy, particularly for polyp removal 2
- Excellent results for smaller fibroids (87% complete resection for fibroids ≤40mm) 3
- Less effective for larger fibroids (only 48% complete resection for fibroids >40mm) 3
Clinical Outcomes
MyoSure demonstrates significant improvements in patient outcomes:
- Symptom improvement: Significant reduction in symptom severity scores at 12 months post-procedure 4
- Quality of life improvement: Health-Related Quality of Life scores increased significantly from baseline to 12 months post-procedure 4
- Bleeding reduction: Reduced bleeding/spotting days from 15.7 to 3.1 days/month when combined with endometrial ablation 5
- Amenorrhea rates: 46% of patients achieved amenorrhea when MyoSure was combined with endometrial ablation 5
Safety Profile
MyoSure demonstrates a favorable safety profile:
- Low complication rates reported across studies
- Mild adverse events that typically resolve spontaneously
- Reported adverse events include blunt cervical trauma and postoperative pedal edema 1
- No intraoperative complications in a prospective analysis of 255 procedures 3
Treatment Settings
MyoSure can be used in various clinical settings:
- Ambulatory surgery centers
- Hospital outpatient departments
- Office-based gynecologic settings
- Both settings demonstrate similar efficacy and patient outcomes 4
Physician Satisfaction
High physician satisfaction has been reported:
- 95% of physicians reported being "satisfied" or "highly satisfied" with device performance 1
- The device can be effectively used by both experienced gynecologists and trainees 3
Limitations and Considerations
Important considerations when using MyoSure include:
- Size limitations: Less effective for fibroids >40mm in diameter 3
- Fluid management: Higher fluid deficit compared to conventional resectoscopy 2
- Learning curve: Though easier to learn than conventional resectoscopy, proper training is still required
- Patient selection: Best results achieved with properly selected patients based on pathology type and size
MyoSure represents an important advancement in the minimally invasive management of intrauterine pathologies, offering a safer and more effective alternative to conventional resectoscopic techniques for appropriate patients.