The histopathology of transcervical resection of the endometrium: an analysis of 200 cases

The results of a series of 200 patients treated by transcervical resection of the endometrium are presented. The failure rate was 20% with a minimum follow up period of 18 months, although seven women (3.5%) had treatment beyond this interval. A second resection was performed in 14 patients with two later requiring a hysterectomy. An additional 26 women proceeded to hysterectomy following the initial resection. Specimen weight was inversely related to the need for further surgery with no secondary operations performed when more than 12 g of endometrium and myometrium had been resected. Age was also correlated with clinical outcome with patients under 35 years of age more likely to require further operative treatment. No histological feature could be identified which predicted failure of the procedure. The main role for histopathological assessment of transcervical resection specimens is in the provision of an accurate weight and the identification of the relatively rare cases harbouring endometrial or myometrial malignancy. Although endometrial resection appears to have resulted in fewer hysterectomies in the treatment of dysfunctional uterine bleeding, long-term follow-up is required before an accurate assessment of success can be established.