HYSTEROSCOPIC MANAGEMENT OF MENSTRUAL DISORDERS - A REVIEW OF 395 PATIENTS

Objective: To evaluate the long-term effectiveness of transcervical re sections in menstrual disorders. Design: Retrospective consecutive pat ient follow-up. Patients: From 1987 to 1993, 395 patients with menstru al disorders (menorrhagia and/or metrorrhagia) were treated with opera tive hysteroscopy in our department. Resection of endometrial polyps w as performed in 65 cases, resection of submucous fibroids in 196, and endometrial ablation in 134. Fourty-one patients had a repeat procedur e. Results: Our mean follow-up period was 2.7 years. Thirteen complica tions were noted (3%), two of which were serious (one hemoperitoneum a fter uterine perforation, one severe symptomatic hyponatremia). Twenty -eight patients did not remain in contact after hospitalization (7.1%) . Menstrual disorders were controlled in 297 patients (75.2%). Failure was noted in 70 patients (17.7%), including hysterectomy in 50 patien ts and persistent bleeding in 20. Conclusion: Hysteroscopic surgery is a satisfying technique for women with abnormal uterine bleeding who w ant a conservation of the uterus. Better results are noted with resect ions of polyps and fibroids than with endometrial ablations.