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Endometrial resection vs. abdominal hysterectomy for menorrhagia. Correlated sample analysis
M Goldenberg1, E Sivan, D Bider
1Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Objective:
To compare hysteroscopic endometrial resection with transabdominal hysterectomy in women with menorrhagia who failed to respond to conservative treatment.
Study Design:
In order to attain correlated samples, only patients with a normal-sized or moderately enlarged uterus were included in the study.
Results:
The operating time, hospital stay and number of women requiring postoperative blood transfusion was significantly lower in the hysteroscopy group. Following hysteroscopy, uterine perforation occurred in three patients, fluid overload in two and dilutional hyponatremia in one. Laparotomy was performed for suspected bowel injury in two cases. The main complication in women undergoing hysterectomy was postoperative fever (36.5%). One case of vesicovaginal fistula was diagnosed seven days postoperatively.
Conclusion:
The results indicate that endometrial resection, with its low cost and prompt recovery, offers a promising alternative treatment for women with abnormal uterine bleeding.