Acta obstetricia et gynecologica Scandinavica · 1998
Follow up of hysteroscopic surgery for menorrhagia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mints M, Rådestad A, Rylander E
Аннотация
OBJECTIVE: A retrospective study of short and long term results of transcervical endomyometrial resection for menorrhagia.
MATERIAL AND METHODS: Patient data were collected from all 104 premenopausal women who had undergone a transcervical endomyometrial resection due to severe menorrhagia in 1990-95. Almost 40% had submucous fibromas that were resected together with the endometrium. A questionnaire about gynecological symptoms was mailed to all 104 women. Ninety-seven (93%) women answered the questionnaire.
RESULTS: The mean follow-up period was 29 months. The following short-term complications were encountered: fluid overload in four, one uterine perforation and one major bleeding. The long-term complications included: three hematometra and one pregnancy ending in a spontaneous abortion. Glandular hyperplasia of the endometrium without atypia was found in two cases, and adenomyosis in 31 (29%) cases. Twenty-one women (21%) became amenorrhoic after the treatment, whereas forty-nine (51%) had minimal menstrual bleeding. Eleven women (11%) suffered from dysmenorrhea. Due to dysmenorrhea and/or persistent menorrhagia thirteen (12.5%) underwent a hysterectomy, generally within one year after the resection. The histological examinations showed adenomyosis in three cases, fibromas in four and fibromas and adenomyosis in three cases.
CONCLUSIONS: In our hands hysteroscopic transcervical endomyometrial resection was a safe and effective treatment for menorrhagia in spite of the fact that amenorrhea was not always achieved. However, dysmenorrhea appeared in 11% of the women. The reason for this remains to be studied. Correct selection criteria is important to get optimal results and reduce the treatment failure.
MATERIAL AND METHODS: Patient data were collected from all 104 premenopausal women who had undergone a transcervical endomyometrial resection due to severe menorrhagia in 1990-95. Almost 40% had submucous fibromas that were resected together with the endometrium. A questionnaire about gynecological symptoms was mailed to all 104 women. Ninety-seven (93%) women answered the questionnaire.
RESULTS: The mean follow-up period was 29 months. The following short-term complications were encountered: fluid overload in four, one uterine perforation and one major bleeding. The long-term complications included: three hematometra and one pregnancy ending in a spontaneous abortion. Glandular hyperplasia of the endometrium without atypia was found in two cases, and adenomyosis in 31 (29%) cases. Twenty-one women (21%) became amenorrhoic after the treatment, whereas forty-nine (51%) had minimal menstrual bleeding. Eleven women (11%) suffered from dysmenorrhea. Due to dysmenorrhea and/or persistent menorrhagia thirteen (12.5%) underwent a hysterectomy, generally within one year after the resection. The histological examinations showed adenomyosis in three cases, fibromas in four and fibromas and adenomyosis in three cases.
CONCLUSIONS: In our hands hysteroscopic transcervical endomyometrial resection was a safe and effective treatment for menorrhagia in spite of the fact that amenorrhea was not always achieved. However, dysmenorrhea appeared in 11% of the women. The reason for this remains to be studied. Correct selection criteria is important to get optimal results and reduce the treatment failure.