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Published on: January 17, 2019
Repeat hysteroscopic surgery reduces the hysterectomy rate after endometrial and myoma resection
1Department of Obstetrics and Gynaecology, Ullevaal Hospital, University of Oslo, Norway.
Study Objective:
To assess the efficacy of repeat transcervical resection of the endometrium (TCRE) in patients with dysfunctional uterine bleeding and myomas in whom primary resection failed.
Design:
Retrospective analysis (Canadian Task Force classification III).
Setting:
University hospital endoscopic unit.
Patients:
Six hundred sixty-eight women.
Intervention:
Repeat TCRE or transcervical resection of a myoma (TCRM).
Measurements And Main Results:
Of 668 patients, 118 (17%) required repeat resection for the following reasons: pain (52, 44%), menorrhagia (39, 31%), myomas (15, 13%), perforation at the primary TCRE (6, 5%), and large fluid deficit during the procedure (6, 5%). Of 118 women undergoing repeat TCRE or TCRM, 33 (28%) eventually required hysterectomy due to pain (17, 48%), persistent bleeding (7, 27%), pain and bleeding (3, 10%), regrowth of myomas (3, 14%), and other reasons (3, 14%).
Conclusion:
Repeat resection is an option after failed primary hysteroscopic operation and may reduce the hysterectomy rate.
