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. 1989 May 6;298(6682):1209–1212. doi: 10.1136/bmj.298.6682.1209

Transcervical resection of endometrium in women with menorrhagia.

A L Magos 1, R Baumann 1, A C Turnbull 1
PMCID: PMC1836233  PMID: 2502218

Abstract

As an alternative to hysterectomy 16 women with menorrhagia were treated with hysteroscopic transcervical resection of the endometrium with an unmodified urological resectoscope. Twelve patients requested total resection of the endometrial lining with the intention of producing amenorrhoea, and four chose partial resection and hypomenorrhoea. Surgery was completed successfully in 15; the remaining woman, who had an acutely retroflexed uterus, sustained a uterine perforation during insertion of the rigid hysteroscope. There were no important postoperative complications, and 13 patients were discharged from hospital the day after operation. Follow up for up to six months showed beneficial effects on the duration of menses and the subjective assessment of menstrual blood loss and pain in the treated women, six of them becoming amenorrhoeic after total resection. Hysteroscopy at three months in 13 patients showed fibrosis confined to the upper half of the uterine cavity. Endouterine biopsy specimens showed the presence of microscopic deposits of normal endometrium in 10 women. Although these results are preliminary, transcervical resection of the endometrium may have an important role in managing this common complaint.

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Selected References

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  1. ASHERMAN J. G. Traumatic intra-uterine adhesions. J Obstet Gynaecol Br Emp. 1950 Dec;57(6):892–896. doi: 10.1111/j.1471-0528.1950.tb06053.x. [DOI] [PubMed] [Google Scholar]
  2. Baggish M. S., Baltoyannis P. New techniques for laser ablation of the endometrium in high-risk patients. Am J Obstet Gynecol. 1988 Aug;159(2):287–292. doi: 10.1016/s0002-9378(88)80069-3. [DOI] [PubMed] [Google Scholar]
  3. Baggish M. S., Woodruff J. D. The occurrence of squamous epithelium in the endometrium. Obstet Gynecol Surv. 1967 Feb;22(1):69–115. doi: 10.1097/00006254-196702000-00008. [DOI] [PubMed] [Google Scholar]
  4. Centerwall B. S. Premenopausal hysterectomy and cardiovascular disease. Am J Obstet Gynecol. 1981 Jan;139(1):58–61. doi: 10.1016/0002-9378(81)90412-9. [DOI] [PubMed] [Google Scholar]
  5. Chimbira T. H., Anderson A. B., Turnbull A. c. Relation between measured menstrual blood loss and patient's subjective assessment of loss, duration of bleeding, number of sanitary towels used, uterine weight and endometrial surface area. Br J Obstet Gynaecol. 1980 Jul;87(7):603–609. doi: 10.1111/j.1471-0528.1980.tb05013.x. [DOI] [PubMed] [Google Scholar]
  6. Cornier E. Traitement hystérofibroscopique ambulatoire des métrorragies rebelles par laser Nd:YAG. J Gynecol Obstet Biol Reprod (Paris) 1986;15(5):661–664. [PubMed] [Google Scholar]
  7. DeCherney A. H., Diamond M. P., Lavy G., Polan M. L. Endometrial ablation for intractable uterine bleeding: hysteroscopic resection. Obstet Gynecol. 1987 Oct;70(4):668–670. [PubMed] [Google Scholar]
  8. DeCherney A. H., Russell J. B., Graebe R. A., Polan M. L. Resectoscopic management of müllerian fusion defects. Fertil Steril. 1986 May;45(5):726–728. doi: 10.1016/s0015-0282(16)49350-7. [DOI] [PubMed] [Google Scholar]
  9. DeCherney A., Polan M. L. Hysteroscopic management of intrauterine lesions and intractable uterine bleeding. Obstet Gynecol. 1983 Mar;61(3):392–397. [PubMed] [Google Scholar]
  10. Dicker R. C., Greenspan J. R., Strauss L. T., Cowart M. R., Scally M. J., Peterson H. B., DeStefano F., Rubin G. L., Ory H. W. Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. The Collaborative Review of Sterilization. Am J Obstet Gynecol. 1982 Dec 1;144(7):841–848. doi: 10.1016/0002-9378(82)90362-3. [DOI] [PubMed] [Google Scholar]
  11. Dicker R. C., Scally M. J., Greenspan J. R., Layde P. M., Ory H. W., Maze J. M., Smith J. C. Hysterectomy among women of reproductive age. Trends in the United States, 1970-1978. JAMA. 1982 Jul 16;248(3):323–327. [PubMed] [Google Scholar]
  12. Droegemueller W., Makowski E., Macsalka R. Destruction of the endometrium by cryosurgery. Am J Obstet Gynecol. 1971 Jun 15;110(4):467–469. doi: 10.1016/0002-9378(71)90685-5. [DOI] [PubMed] [Google Scholar]
  13. Gloag D. Epilepsy and employment. Br Med J (Clin Res Ed) 1985 Jul 6;291(6487):2–3. doi: 10.1136/bmj.291.6487.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Goldrath M. H., Fuller T. A., Segal S. Laser photovaporization of endometrium for the treatment of menorrhagia. Am J Obstet Gynecol. 1981 May 1;140(1):14–19. doi: 10.1016/0002-9378(81)90251-9. [DOI] [PubMed] [Google Scholar]
  15. Grant J. M., Hussein I. Y. An audit of abdominal hysterectomy over a decade in a district hospital. Br J Obstet Gynaecol. 1984 Jan;91(1):73–77. doi: 10.1111/j.1471-0528.1984.tb05282.x. [DOI] [PubMed] [Google Scholar]
  16. Haning R. V., Jr, Harkins P. G., Uehling D. T. Preservation of fertility by transcervical resection of a benign mesodermal uterine tumor with a resectoscope and glycine distending medium. Fertil Steril. 1980 Feb;33(2):209–210. doi: 10.1016/s0015-0282(16)44546-2. [DOI] [PubMed] [Google Scholar]
  17. Haynes P. J., Hodgson H., Anderson A. B., Turnbull A. C. Measurement of menstrual blood loss in patients complaining of menorrhagia. Br J Obstet Gynaecol. 1977 Oct;84(10):763–768. doi: 10.1111/j.1471-0528.1977.tb12490.x. [DOI] [PubMed] [Google Scholar]
  18. Loffer F. D. Laser ablation of the endometrium. Obstet Gynecol Clin North Am. 1988 Mar;15(1):77–89. [PubMed] [Google Scholar]
  19. Neuwirth R. S. A new technique for and additional experience with hysteroscopic resection of submucous fibroids. Am J Obstet Gynecol. 1978 May 1;131(1):91–94. doi: 10.1016/0002-9378(78)90481-7. [DOI] [PubMed] [Google Scholar]
  20. Rees M. Menorrhagia. Br Med J (Clin Res Ed) 1987 Mar 21;294(6574):759–762. doi: 10.1136/bmj.294.6574.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Richards D. H. A post-hysterectomy syndrome. Lancet. 1974 Oct 26;2(7887):983–985. doi: 10.1016/s0140-6736(74)92074-1. [DOI] [PubMed] [Google Scholar]
  22. Rybo G. Clinical and experimental studies on menstrual blood loss. Acta Obstet Gynecol Scand. 1966;45(Suppl):1–23. doi: 10.3109/00016346609158476. [DOI] [PubMed] [Google Scholar]
  23. Schenker J. G., Polishuk W. Z. Regeneration of rabbit endometrium following intrauterine instillation of chemical agents. Gynecol Invest. 1973;4(1):1–13. doi: 10.1159/000301703. [DOI] [PubMed] [Google Scholar]
  24. Siddle N., Sarrel P., Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril. 1987 Jan;47(1):94–100. doi: 10.1016/s0015-0282(16)49942-5. [DOI] [PubMed] [Google Scholar]
  25. Wingo P. A., Huezo C. M., Rubin G. L., Ory H. W., Peterson H. B. The mortality risk associated with hysterectomy. Am J Obstet Gynecol. 1985 Aug 1;152(7 Pt 1):803–808. doi: 10.1016/s0002-9378(85)80067-3. [DOI] [PubMed] [Google Scholar]

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