[Endometrial resection for refractory menorrhagia. An alternative to hysterectomy].

UNLABELLED: ENDOMETRIAL RESECTION: Whether resection is total or partial, the superficial layer of the myometrium is exposed to a certain degree of damage.

SEVERAL

METHODS

Radiofrequency thermal resection, the standard method, offers the advantage of allowing histology examination. Other destructive methods have also been proposed including the more recent laser Ng-Yag ablation technique.

INDICATION: Ideally, endometrial resection is indicated in women with a small uterus who develop drug resistant menometrorrhagia after the age of 40 years.

MODERATE RATE OF SUCCESS: In a personal series of 105 patients who underwent radiofrequency thermal resection and with a mean follow-up of 15.5 +/- 6.6 months, results were in agreement with data reported in the literature: perforation of the uterus < 5%, hemorrhage < 1%, metabolic syndrome < 2%. Patients were entirely satisfied in 58% of the cases but secondary hysterectomy was required in 14%.

PRECISE INDICATIONS: Despite the advantages over hysterectomy, endometrial resection should be reserved for selected patients in order to avoid an unsatisfactory high rate of failure.