[Transcervical resection of the endometrium. An alternative to hysterectomy in dysfunctional uterine hemorrhage]

Transcervical electroresection of the endometrium was performed in 104 patients with dysfunctional uterine bleeding which did not respond to conservative treatment. Transcervical resection was offered as an alternative to abdominal hysterectomy. Re-resection was performed in 17 women (16%) because the initial section did not have the desired effect. Altogether 122 resections were performed. 79% of the women were satisfied after the initial resection and 93% when the procedure was repeated. During a follow-up period of six to 28 months after treatment, a hysterectomy was performed in 18 (17%) patients, but unacceptable uterine bleeding was the indication in only five of these cases. One major complication occurred, a small bowel perforation which required intestinal resection. Three uterine perforations occurred without any damage to neighbouring organs. Except for transient headache in a few patients, no clinical symptoms of glycine toxicity were seen. It is concluded that transcervical endometrial resection seems to represent an additional option for surgical treatment of dysfunctional uterine bleeding, but the procedure is not without risk. The long-term results of this procedure must be compared with those achieved by traditional abdominal hysterectomy.