[Endometrial resection for refractory menorrhagia. An alternative to hysterectomy]

ENDOMETRIAL RESECTION: Whether resection is total or partial, the superficial layer of the myometrium is exposed to a certain degree of damage.

Radiofrequency thermal resection, the standard method, offers the advantage of allowing histology examination. Other destructive methods have also been proposed including the more recent laser Ng-Yag ablation technique.

Ideally, endometrial resection is indicated in women with a small uterus who develop drug resistant menometrorrhagia after the age of 40 years.

In a personal series of 105 patients who underwent radiofrequency thermal resection and with a mean follow-up of 15.5 +/- 6.6 months, results were in agreement with data reported in the literature: perforation of the uterus < 5%, hemorrhage < 1%, metabolic syndrome < 2%. Patients were entirely satisfied in 58% of the cases but secondary hysterectomy was required in 14%.

Despite the advantages over hysterectomy, endometrial resection should be reserved for selected patients in order to avoid an unsatisfactory high rate of failure.