AUTHOR=Tinelli Andrea , Mynbaev Ospan , Panese Gaetano , Licchelli Martina , Pecorella Giovanni , Malvasi Antonio , Kosmas Ioannis , Stark Michael , Cao Wenming 

TITLE=Cervical fibroids: the vaginal intracapsular myomectomy with classification by the fibroids’ origin, growth directions, and localizations

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1564667

DOI=10.3389/fmed.2025.1564667

ISSN=2296-858X

ABSTRACT=Aim of the studyTo define the impact of cervical fibroids (CFs) localization, size, and their combined presence on the feasibility of performing cervical intracapsular myomectomy (CIME) by using a vaginal approach.ObjectiveEvaluation of the feasibility of conducting CIME via the transvaginal approach.Materials and methodsThis retrospective cohort observational study included 32 patients who underwent CIME. The findings were evaluated by comparing them with the outcomes of 1,204 patients with CFs reported in the English and Chinese literature.ResultsThe study demonstrated that CIME by vaginal approach can be successfully performed on CFs with a mean size of 8.08 cm (95% CI: 7.44–8.73 cm) for extracervical anterior and posterior sites, 7.61 cm (95% CI: 7.09–8.14 cm) for extracervical and intracervical lateral localizations, and 5.36 cm (95% CI: 4.71–6.35 cm) for combined CFs in two different localization sites. The feasibility and efficiency of the suggested CIME technique were confirmed through a comparative analysis of perioperative endpoints from 326 vaginal, 643 laparoscopic, and 235 laparotomic myomectomies documented in the literature.ConclusionThe findings highlight key issues related to the suggested original CIME technique performed via a direct vaginal approach. They also provide a comprehensive classification of CFs along with the CFs’ clinical manifestations based on the type of growth direction, locations, and fibroid maturity. These findings may have implications for managing patients with CFs.