This is a case of a 34 year old female, G2P2 who presented with menometrorrhagia unresponsive to hormone therapy. A pelvic ultrasound identified the pedunculated, mobile intrauterine mass consistent with either a leiomyoma or a polyp. Subsequent histologic examination identified the mass as a leiomyoma.

The loop of the resectoscope can be seen in the foreground at the internal os of the cervix and the myoma in the background. The endometrium appears atrophic because the patient was treated preoperatively with a GnRH agonist to diminish the size of the myoma and, as a result, decrease the operating time. Long term GnRh agonist therapy is not recomended because of the hypoestrogenic side effect of bone loss with long term treatment. If bleeding occurs despite the electocoagulation technique and GnRH agonist pretreatment, a balloon catheter can be inserted into the endometrial cavity postoperatively to tamponade the bleeding sites. It can be deflated several hours after surgery, and removed if the bleeding has ceased.