Submucous fibroids: A new presurgical classification (STEP-w) - Ricardo Lasmar, Paulo Barrozo, Rogeiro Dias e Marco A. Oliveira


This link was last updated on November 08, 2005.


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.


Ricardo Bassil Lasmar, MD, PhD

Paulo Roberto Mussel Barrozo, MD, PhD

Rogério Dias, MD, PhD

Marco Aurélio Pinho de Oliveira, MD, PhD


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



MANAGEMENTE PROTOCOL



REFERENCE


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