Table 2.
Surgical reintervention during follow-up according to histopathology and clinical symptoms.
| Baseline symptoms | Symptoms at 6 months follow-up | Use of analgesics after TCREα | Use of IUD after TCRE | Surgical reintervention | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Histopathology | SS | HR-QoL | Pelvic pain (VAS intensity %) | SS | HR-QoL | Pelvic pain (VAS intensity %) | ||||
| #1 | Adenomyosis of the inner myometrium | 37.5 | 56.0 | During (39) and between menstruation (30) | Hysterectomy | |||||
| #2 | Adenomyosis of the inner myometrium | 59.4 | 57.8 | No | Repeat TCRE* | |||||
| #3 | Serrated junctional zone | 53.1 | 40.5 | During (30) and between menstruation (15) | Hysterectomy | |||||
| #41 | Linear junctional zone | 56.3 | 50.0 | During (30) and between menstruation (88) | 21.9 | 93.7 | Between menstruation (87) | Yes | Yes | Hysterectomy |
| #5 | Adenomyosis of the inner myometrium | 62.5 | 41.4 | During (87) and between menstruation (62) | 56.3 | 46.6 | During (90) and between menstruation (70) | Yes | Yes | Repeat TCRE* |
| #6 | Adenomyosis of the inner myometrium | 53.1 | 75.9 | No | 18.8 | 89.7 | During menstruation (22) | Yes | No | Repeat TCRE* |
| #7 | Adenomyosis of the inner myometrium | 78.1 | 42.2 | No | 43.8 | 81.0 | No | No | No | Hysterectomy |
| #8 | Adenomyosis of the inner myometrium | 62.5 | 42.2 | During (71) and between menstruation (65) | 15.6 | 90.5 | Between menstruation (14) | Yes | No | Hysterectomy |
| #92 | Linear junctional zone | 56.3 | 75.0 | During (77) and between menstruation (71) | 53.1 | 82.8 | During (56) and between menstruation (58) | Yes | Yes | Hysterectomy |
| #10 | Serrated junctional zone | 12.5 | 80.2 | No | 9.4 | 69.8 | Between menstruation (23) | No | Yes | Hysterectomy |
| #11 | Serrated junctional zone | 50.0 | 44.8 | During menstruation (78) | Hysterectomy | |||||
| #12 | Serrated junctional zone | 18.8 | 81.9 | During (85) and between menstruation (80) | Hysterectomy | |||||
| #13 | Adenomyosis of the inner myometrium | 71.9 | 63.8 | During (65) and between menstruation (23) | 6.3 | 90.5 | No | No | No | Hysterectomy |
| #14 | Adenomyosis of the inner myometrium | 62.5 | 49.1 | During menstruation (72) | 53.1 | 61.2 | During menstruation (54) | Yes | No | Hysterectomy |
| #15 | Linear junctional zone | 34.4 | 30.2 | No | 65.6 | 7.8 | During (63) and between menstruation (60) | Yes | No | Hysterectomy |
TCRE: Transcervical resection of the endometrium. SSS: Symptom severity. HR-QoL: Health-related quality of life. VAS: Visual analogue scale. IUD: Intrauterine device.
#1-3 had surgical reintervention < 6 months after TCRE, #4-12 had surgical reintervention 6–18 months after TCRE and #13-15 had surgical reintervention > 18 months after TCRE (before January 2018). Follow-up questionnaire missing in #11 and #12.
* All three patients had subsequently hysterectomy due to persisting symptoms.
Presence or absence of adenomyosis of the inner myometrium was verified in all hysterectomy specimens except for patient #2. This patient had one foci of adenomyosis of the inner myometrium, and it is likely that this foci may have been removed by repeat TCRE prior to hysterectomy.
α Reported use at 6 months follow-up, including paracetamol, aspirin, non-steroidal anti-inflammatory drugs.
1 Concomitant uterine polyps.
2 Concomitant leiomyomas.