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Emergency endometrial resection in women with acute, severe uterine bleeding
1Department of Obstetrics and Gynecology, Santa Maria Annunziata Hospital, Florence, Italy.
Study Objective:
To evaluate the efficacy and safety of endometrial hysteroscopic resection in the treatment of severe uterine bleeding.
Design:
Pilot feasibility study (Canadian Task Force classification II-2).
Setting:
Department of gynecology at a general hospital.
Patients:
Twenty-six women with severe uterine bleeding.
Intervention:
Hysteroscopic transcervical endometrial resection under general anesthesia.
Measurements And Main Results:
Bleeding had a benign organic cause in 25 women. One endometrial carcinoma was detected in endometrial chips in a postmenopausal woman and was managed with hysterectomy. Fifteen cycling women experienced complete remission of uterine bleeding; one underwent hysterectomy during follow-up. Atrophic endometrium was present in nine menopausal women during follow up.
Conclusion:
Endometrial transcervical resection was effective in controlling heavy bleeding, preventing future episodes of severe bleeding, and avoiding further medical or surgical treatment during 19 months of follow-up.