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
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 |
![]() |
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.