Endometrial Resection and Late Reoperation in the Treatment of Menorrhagia

We evaluated the effectiveness of transcervical resection of the endometrium (TCRE) and the indications of late reoperations in 250 women with dysfunctional bleeding. The women were questioned about symptoms and levels of satisfaction 3, 12, 24, 36, and 48 months after the procedure. Average follow-up was 24 months (range 4-48 mo). Repeat resection was performed in 8 women (3.2%) and hysterectomy in 13 (5.2%). Seven women (2.8%) had reoperation because of recurrent unacceptable vaginal bleeding. Late onset of pain occurred in 14 (5.6%). The success rate at 3 months as measured by patient satisfaction was 97% and at 4 to 45 months 91%. A definite subgroup of women developed late onset of pain with or without bleeding after endometrial resection. Results at 3 months did not necessarily correlate with longer-term outcomes. Provided that the surgeon has extensive training, few women will be dissatisfied with the procedure.