Modern surgical technologies allow gynecologists to treat most submucosal
myomas hysteroscopically by some form of resection. What appears on imaging or direct visualization to be a submucosal
myoma can be a single
tumor, or may represent multiple smaller
myomas appearing as one, compacted together in a typical pseudo
capsule. During
myoma resection, the effect of the media used to induce distension can vary, depending on the morphology of the
myomas. After starting resection, the pressure of the distending media can push truly solitary
myomas to somewhat flatten against the uterine wall. However, in the second type of
myoma, the fluid can displace the
myomas into the uterine cavity, an appearance similar to the blooming of a flower. The tip of the
hysteroscope may enter the dissected spaces between the
myomas, which impairs the panoramic view. This phenomenon may cause inadequate treatment of the
myomas encountered during hysteroscopic
myomectomy. In this study, the “Blooming phenomenon” is introduced, and the problems created by this phenomenon and solutions for its management are considered.