Experience with the first 250 endometrial resections for menorrhagia

Area of Science:

• Gynecology
• Minimally Invasive Surgery

Background:

• Menorrhagia significantly impacts women's quality of life.
• Hysterectomy is a definitive treatment but carries substantial risks.
• Transcervical resection of the endometrium (TCRE) presents a less invasive alternative.

Purpose of the Study:

• To evaluate the safety and efficacy of hysteroscopic transcervical resection of the endometrium (TCRE) for treating menorrhagia.
• To assess patient outcomes, including symptom improvement, complications, and long-term results.

Main Methods:

• A retrospective analysis of 234 patients undergoing TCRE for menorrhagia.
• Procedures performed under general or local anesthesia with sedation.
• Endometrial excision (total or partial) with or without simultaneous submucous fibroid resection.

Main Results:

• Over 90% of patients experienced significant improvement in menstrual symptoms.
• Amenorrhea occurred in 27-42% of women after total TCRE.
• Low complication rates (2% uterine perforation, 3% excessive fluid absorption).
• Hospital stay was short, with recovery typically within 1-2 weeks.

Conclusions:

• TCRE is a safe and effective hysteroscopic treatment for menorrhagia, offering substantial symptom relief.
• The procedure is well-tolerated with minimal complications and short recovery times.
• TCRE provides a valuable alternative to hysterectomy for women with menorrhagia, particularly those over 35.