[Hysteroscopically guided endometrial destruction in the treatment of menorrhagia]

Until recently, hysterectomy has been the alternative method of treatment in cases of premenopausal menorrhagia where it has not proved possible to obtain satisfactory regulation of the haemorrhage by medical means. Within recent years, a series of hysteroscopic methods have been developed for selective destruction of the endometrium by means of neodymium-laser, electroresection and coagulation. Compared with hysterectomy, hysteroscopic destruction of the endometrium appears to be a much more rapid, simpler and cheaper form of treatment of menorrhagia and appears to be associated with considerably fewer complications. The duration of hospitalization and the period of convalescence can be reduced considerably but, primarily, a large group of women can avoid hysterectomy. As yet, no controlled investigations of selective destruction of the endometrium as compared with conventional hysterectomy are available. There are no comparative investigations of the different methods nor of the long-term sequelae after destruction of the endometrium. This method of treatment has hitherto only been employed to a limited extent in Denmark. Coordination of the activities in this field in connection with establishing this form of treatment in Denmark should be encouraged.