This article should be cited as:

Lasmar RB, Barrozo PRM, Dias R, Oliveira MAP. Submucous fibroids: A new presurgical classification (STEP-w) to evaluate the viability of hysteroscopic surgical treatment - Preliminary report. in: http://www.histeroscopia.med.br/. Access in:

keywords: hysteroscopy, submucous fibroids, step-w classification, treatment, managemente protocol, hysteroscopic surgeries, resectoscope.

Submucous fibroids: A new presurgical classification (STEP-w) to evaluate the viability of hysteroscopic surgical treatment - Preliminary report.

Gynecological Endoscopy Sector, Gynecology Department of the Botucatu Medical Faculty, Paulista State University (Drs. Lasmar, Barrozo and Dias), São Paulo, Brazil. Gynecology Department of the State University of Rio de Janeiro (Drs. Lasmar and Oliveira) Rio de Janeiro, Brazil.

CONTACT

Ricardo Lasmar MD, PhD Rua Voluntários da Pátria 126 sala 602 Botafogo, Rio de Janeiro, Brazil CEP:22270-010 Tel: 55-21-25372321   ricardo@lasmar.com.br www.ginendo.com

RATIONALE

With the objective of establishing a surgical prognosis and enabling a valid comparison of the results of the hysteroscopic myomectomy, it is essential to have a more wide-ranging classification system that can group together procedures of the same level of difficulty; however, the classification system of the European Society for Gynaecological Endoscopy (ESGE) considers only the degree of penetration of the submucous fibroid in the myometrium.

The objective of this study was to develop a classification system (STEP-w) for hysteroscopic myomectomies based on the degree of technical difficulty in carrying out the procedure and to recommend the most suitable course of action in each situation.

STEP-w Classification

.Size

0 - ≤ 2cm

1 - 2cm a 5cm

2 - > 5cm

.Topography

0 - Inferior

1 - Middle

2 - Upper

.Extention of the base

0 - ≤1/3 of the base

1 - >1/3 to ≤ 2/3 of the base

2 - > 2/3 of the base

.Penetration

ame ESGE classification

0 - Fibroids totaly in cavity

1 - More than 50% in cavity

2 - Less than 50% in cavity

Wamsteker K, 1993

.Lateral wall

Add 1 point to the TOTAL score if Myoma is sited at the lateral wall

ESCORE

SCORE SYSTEM

CLASSIFICATION

REFERENCE

Lasmar RB, Barrozo PRM, Dias R, Oliveira MAP. J Minim Invasive Gynecol. 2005 Jul-Aug;12(4):308-11.