A woman presented with complaints of heavy menstrual flow, a noticeable increase in the number of sanitary pads used per day, prolonged menstrual cycles, & passage of clots. Over time, she began to experience a significant loss of stamina & fatigue in carrying out her daily chores.

On evaluation, her pelvic sonography revealed a Submucous Fibroid within the uterine cavity & a marked drop in her haemoglobin levels. On clinical examination, she was found to be anaemic, though no significant findings were noted on internal examination.

Considering her symptoms & the degree of anaemia, she was counselled regarding the need for early surgical management to prevent further blood loss during subsequent menstrual cycles.

Submucous fibroids, located within the cavity of the uterus, typically present with heavy menstrual flow, passage of clots, & pain during periods. If neglected, they can lead to anaemia, causing tiredness, lethargy, & reduced energy levels. A transvaginal sonography (TVS) of the pelvis remains the best diagnostic tool to identify  & assess these fibroids.

Since medical management has no role in treating Submucous Myomas, the definitive treatment is Operative Hysteroscopy (Hysteroscopic Myomectomy). The procedure was explained in detail to the patient, & she underwent Hysteroscopic Myomectomy under anaesthesia.

During surgery, no incisions were made on the abdominal wall. The procedure was performed through the natural birth passage using a hysteroscope, which allowed direct visualisation of the uterine cavity. The fibroid was identified & removed using an energy source.

Post-procedure, the patient had minimal vaginal bleeding & recovered well. She was discharged the next morning. At her follow-up visit, she reported improved energy levels & a significant reduction in menstrual bleeding.

It is recommended that patients undergo routine pelvic sonography once a year, or earlier if any menstrual irregularities recur.