Transcervical endometrial resection in women with menorrhagia: Long-term follow-up

• Published in: European journal of obstetrics & gynecology and reproductive biology 2006-03, Vol.125 (1), p.99-102
• Main Authors: Litta, Pietro, Merlin, Federica, Pozzan, Chiara, Nardelli, Giovanni Battista, Capobianco, Giampiero, Dessole, Salvatore, Ambrosini, Antonio
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biological and medical sciences; Endometrial resection; Endometrium - surgery; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Long-term follow-up; Medical sciences; Menorrhagia; Menorrhagia - pathology; Menorrhagia - surgery; Middle Aged; Non tumoral diseases; Premenopause; Reoperation - statistics & numerical data; Retrospective Studies; Treatment Outcome
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2005.07.017

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. 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° loop for intrauterine walls and used with glycine 1% as distending fluid) between 1994 and 1999. 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. 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.