Transcervical endometrial resection in women with menorrhagia: long-term follow-up.
OBJECTIVE
Hysteroscopic endometrial resection is an innovative and conservative surgical technique considered, very often, as an alternative to hysterectomy. The aim of the study was to evaluate long-term efficacy of endometrial resection performed in women with menorrhagia.


METHODS
Retrospective study of 111 premenopausal women with menorrhagia, unresponsive to medical treatment, who underwent endometrial resection by resectohysteroscope (electrocautery technique supplied with a fundus rollerball electrode, with corneal areas, and with a 90 degrees loop for intrauterine walls and used with glycine 1% as distending fluid) between 1994 and 1999.


RESULTS
Long-term follow-up questionnaires were completed in 106 cases, while 5 cases dropped-out (4.5%). The mean-age at menopause in our subjects was 52.8 years (17.6+/-18.4 months after operation). After 53.2+/-16.4 months, 82 patients (77.4%) showed a normal menstrual pattern or amenorrhea, while failure was recorded in 24 patients (22.6%) and 12/24 patients underwent hysterectomy. Percentage of success in the older population (>49 years) (94%) was significantly higher than in the younger population (70%). The histologic finding of only fibrosis (41.7%) correlated with failure of the technique.


CONCLUSIONS
Our data suggest that endometrial resection by resectohysteroscope is an innovative and conservative but not exclusive surgical technique in selected younger women, while in older women endometrial resection nearly always resolves long-term menorrhagia.
Litta
Pietro
P
Department of Gynecological Science and Human Reproduction, University of Padua, Padua, Italy.
Merlin
Federica
F
Pozzan
Chiara
C
Nardelli
Giovanni Battista
GB
Capobianco
Giampiero
G
Dessole
Salvatore
S
Ambrosini
Antonio
A
D000328:Adult; D000367:Age Factors; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008595:Menorrhagia / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D017697:Premenopause; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome