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[Failure factors in endometrial resection. 196 cases]
J Raiga1, J Bowen, E Glowaczower
1Polyclinique Gynécologie-Obstétrique, Hôtel-Dieu, CHU Clermont-Ferrand.
Objective:
Study of factors affecting risk of failure after hysteroscopic endometrial resection.
Methodology:
A retrospective study of 196 patients treated by hysteroscopic endometrial resection for abnormal uterine bleeding from January 1989 to December 1990. A survey was conducted in February 1993 to study the results of these interventions with a particular attention paid to the failure cases.
Results:
The survey revealed a satisfaction rate of 82%. Persistence of abnormal bleeding after resection was the most common problem reported, although in 32% of these cases the bleeding began after a period of at least 2 years in remission. A more complete clinical and pathological study was performed in 22 cases of hysterectomy for failure after resection. Enlarged uterine size and presence of adenomyosis increase significantly the failure rates.
Conclusion:
After 2 or 4 years of follow-up, the results are satisfactory but the existence of late recurrences showed that it will be necessary to have long term reviews. Two major risk factors are enlarged uterine size and the presence of adenomyosis.