Innovations in transvaginal fibroid treatment

Fibroids are a common gynaecological problem in women of reproductive age. They can cause symptoms of heavy menstrual bleeding, pain during menstruation and pain/pressure in the lower abdomen. This can negatively affect quality of life. Myomas can be located at different positions in the uterus, with the localisation determining which treatment options are available. This thesis focuses on transvaginal treatment of fibroids and developments within this field. It provides insight on the long-term outcomes of hysteroscopic myomectomy and Sonata treatment of fibroids and the amount and quality of research that has been done on outcomes of hysteroscopic myomectomy for heavy menstrual bleeding. Furthermore, it investigates the use of procedural sedation and analgesia with propofol for gynaecologic surgery and the (cost)effectiveness of procedural sedation and analgesia versus general anaesthesia for hysteroscopic myomectomy in particular.