1. Hysteroscopic classification of submucous
fibroids
Wamsteker’s classification
0 - Fibroids totally in cavity
1 - More than 50% in cavity
2 - Less than 50% in cavity
II
0
Adopted by ESGE
II
I

2. Lasmar’s pre-surgical classification
Size of the fibroid
Topography Score: 0 – 2
Based on total score,
Extension of the base of fibroid patients are allocated
into three groups
Penetration into myometrium
STEP-W classification

3. Size Topography
0 - ≤ 2cm 0 - Lower
1 - 2cm - 5cm 1 - Middle
2 - > 5cm 2 - Upperr

4. Lateral wall
Extension of the base Penetration
0 - ≤1/3 of the wall 0 - Fibroids totally in cavity
1 - More than 50% in cavity
1 - >1/3 to ≤ 2/3 of the wall
2 - Less than 50% in cavity
2 - > 2/3 of the wall
Add 1 point to the TOTAL score if Myoma is
situated in the lateral wall

5. SCORE

7. SCORE SYSTEM

8. MANAGEMENT PROTOCOL
d

9. Significance of STEP-W classification
Higher correlation with
• Completeness of myomectomy
• Duration of surgery
• Fluid deficit