Randomised controlled trial comparing endometrial resection with abdominal hysterectomy for the surgical treatment of menorrhagia.
OBJECTIVE
To evaluate the effectiveness of endometrial resection as a surgical treatment for menorrhagia.


METHODS
Randomised controlled trial.


METHODS
Gynaecology department at a teaching hospital.


METHODS
Two hundred women needing surgical treatment for menorrhagia between January 1990 and May 1991. After withdrawal of four women 97 underwent hysterectomy and 99 underwent endometrial resection.


METHODS
Patient satisfaction 4 months after surgery; post-operative complications; length of hospital stay; duration of time before return to work, normal daily activities and sexual intercourse; change in premenstrual symptoms.


RESULTS
The difference in patient satisfaction between endometrial resection (84 out of 99) and abdominal hysterectomy (89 out of 95) just reached statistical significance in favour of abdominal hysterectomy at 4 months after surgery (difference = 9%, 95% confidence intervals (CI) 1.1%-17.5%). Post-operative morbidity, length of hospital stay and time taken to return to work, normal daily activities and sexual intercourse were significantly less in the endometrial resection group. However, the premenstrual symptoms of dysmenorrhoea, bloating and breast tenderness were less frequent after hysterectomy.


CONCLUSIONS
In the short term, endometrial resection was almost as satisfactory as abdominal hysterectomy for the surgical treatment of menorrhagia, and was associated with less morbidity. However, even at 4 months after surgery, there was a failure rate of at least 10% in those in whom endometrial resection appeared complete. Longer term comparative studies are necessary before the widespread introduction of endometrial resection as an alternative to abdominal hysterectomy for the surgical treatment of menorrhagia.
Dwyer
N
N
St Michael's Hospital, Bristol, UK.
Hutton
J
J
Stirrat
G M
GM
D000203:Activities of Daily Living; D000465:Algorithms; D003075:Coitus; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000523:psychology; D007902:Length of Stay; D008595:Menorrhagia / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011293:Premenstrual Syndrome; D013997:Time Factors