[What role should hysterectomy play in benign uterine lesions?]

Since the beginning of the nineties, we have seen an increase in the use of operative hysteroscopy in the surgical treatment of women with dysfunctional uterine bleeding. The aim of this article is to show that these new techniques are surgical acts subject to complications, failures, morbidity and indeed mortality. It seems therefore reasonable to ask whether vaginal hysterectomy represents a good alternative to endometrial ablation. We think so both in terms of functional or clinical results, and cost or quality of life. The endometrial ablation should be reserved to women who have strictly dysfunctional pathologies. In all cases, the difficulty in the diagnosis of adenomyosis, the high rate of failure of endometrial ablation, the degradation of its results with time and finally the better quality of life after hysterectomy must be exposed clearly to all patients. It will be with full knowledge of the facts, that women will be able to choose between radical surgical treatment represented by hysterectomy and so-called conservative surgical treatments.