- M D Damewood: Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland.
Uterine reconstructive surgery may be accomplished through both the abdomen and the hysteroscope. It is important to obtain a complete evaluation of infertility or repeated pregnancy wastage prior to surgery. Newer approaches include the hysteroscopic resection of the uterine septum and medical therapy with GnRH analogues for reduction of fibroid size, volume, and symptoms. In some instances, larger fibroids may be approached through the hysteroscope or resectoscope after medical therapy.