HYSTEROSCOPIC SURGERY IN POSTMENOPAUSAL WOMEN

Objective. To assess the efficacy of hysteroscopic surgery in postmeno pausal women presenting with abnormal uterine bleeding. Design. A retr ospective audit of 102 patients. Setting. The Department of Obstetrics and Gynecology B, La Conception Hospital, Marseilles, France. Patient s. One hundred and two women between the ages of 47-67 years with post menopausal bleeding or bleeding related to hormone replacement therapy were evaluated by pelvic ultrasound and diagnostic hysteroscopy. A be nign organic cause was noted in 87 cases (polyps in 51 and fibroids in 36). Fifteen patients had no significant disease. Interventions. Rese ction of polyps or fibroids, endometrial ablation. Results. One hundre d and seven procedures were performed on 102 patients. Major operative complications were rare and included one perforation and one case of glycine toxicity. Eighty-eight patients were satisfied with the result s. Six patients were subsequently treated by hysterectomy. Six patient s complained of recurrent abnormal bleeding. Conclusions. This modalit y of treatment appears to be effective over the long term. The operati ve criteria should take the causes of bleeding and not just the age of the patient into account.