A 34-year-old woman with heavy menstrual bleeding and secondary infertility has a submucosal fibroid on saline infusion sonography. For complete hysteroscopic resection in a single sitting, the ideal lesion according to the FIGO classification is:

• A Type 5, subserosal with less than 50 percent intramural extension
• B Type 2, with more than 50 percent intramural extension
• C Type 3, abutting the endometrium but entirely intramural
• D Type 0, entirely within the cavity on a narrow pedicle ✓

Explanation

In the FIGO subclassification of submucosal fibroids, type 0 lesions are pedunculated and wholly intracavitary, making them fully accessible to the hysteroscope with minimal risk of incomplete removal or perforation. Type 1 (<50 percent intramural) can often be resected hysteroscopically but may need staged procedures. Type 2 (>50 percent intramural) requires advanced techniques such as two-step resection. Type 3 is entirely intramural and needs abdominal or laparoscopic approach, while type 5 is subserosal.

Reference: Berek and Novak's Gynecology, 16th ed.

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Written and medically reviewed by the StethoPrep medical team.