title: Hysteroscopic transcervical endometrial resection versus thermal destruction for menorrhagia: a prospective randomized trial on satisfaction rate.
abstract: OBJECTIVE
  The purpose of this study was to compare the satisfaction rate and the effectiveness of transcervical hysteroscopic endometrial resection and thermal destruction of the endometrium in the treatment of menorrhagia.
  
  
  METHODS
  A prospective randomized trial with 2 years of follow-up was carried out in the Department of Gynecology of the University of Naples. Eighty-two patients who were affected by menorrhagia that was unresponsive to medical treatment were respectively randomized to transcervical hysteroscopic endometrial resection or to thermal destruction of the endometrium. Satisfaction rate, operative time, discharge time, complication rate, reintervention rate, and resumption of normal activity were evaluated in each group.
  
  
  RESULTS
  The satisfaction rate was significantly higher in the thermal destruction group. Operative time was significantly shorter in the thermal destruction group (24 +/- 4 minutes vs 37 +/- 6 minutes). Intraoperative blood loss was significantly lower in the thermal destruction group (7.2 +/- 2.8 mL vs 89 +/- 38 mL). Reintervention rates were higher in the transcervical hysteroscopic endometrial resection group, although postoperative pain was not significantly different between the two groups. Discharge time, complication rate, and resumption of normal activity were not significantly different between the two groups.
  
  
  CONCLUSIONS
  Thermal destruction of the endometrium for the treatment of menorrhagia should be considered an effective therapeutic option because of its acceptability among patients, shorter operative time, and lower blood loss.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Medicine, University of Naples Federico II, Italy. pellican@unina.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Pellicano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Acunzo
authors.forename: Domenico
authors.initials: D
authors.lastname: Cirillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bifulco
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies