Repeat hysteroscopic surgery reduces the hysterectomy rate after endometrial and myoma resection.
OBJECTIVE
To assess the efficacy of repeat transcervical resection of the endometrium (TCRE) in patients with dysfunctional uterine bleeding and myomas in whom primary resection failed.


METHODS
Retrospective analysis (Canadian Task Force classification III).


METHODS
University hospital endoscopic unit.


METHODS
Six hundred sixty-eight women.


METHODS
Repeat TCRE or transcervical resection of a myoma (TCRM).


RESULTS
Of 668 patients, 118 (17%) required repeat resection for the following reasons: pain (52, 44%), menorrhagia (39, 31%), myomas (15, 13%), perforation at the primary TCRE (6, 5%), and large fluid deficit during the procedure (6, 5%). Of 118 women undergoing repeat TCRE or TCRM, 33 (28%) eventually required hysterectomy due to pain (17, 48%), persistent bleeding (7, 27%), pain and bleeding (3, 10%), regrowth of myomas (3, 14%), and other reasons (3, 14%).


CONCLUSIONS
Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate.
Department of Obstetrics and Gynaecology, Ullevaal Hospital, University of Oslo, Norway.
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Langebrekke
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000706:statistics & numerical data*; D015907:Hysteroscopy / Q000379:methods*; D015994:Incidence; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011336:Probability; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*