ENDOMETRIAL RESECTION FOR RECURRENT MENOR RHAGIA - AN ALTERNATIVE TO HYSTERECTOMY

Endometrial resection: Whether resection is total or partial, the supe rficial layer of the myometrium is exposed to a certain degree of dama ge. Several methods: Radiofrequency thermal resection, the standard me thod, offers the advantage of allowing histology examination. Other de structive methods have also been proposed including the more recent la ser Ng-Yag ablation technique. Indication: ideally endometrial resecti on is indicated in women with a small uterus who develop drug resistan t menometrorrhagia after the age of 40 years. Moderate rate of success : In a personal series oi 105 patients who underwent radiofrequency th ermal resection and with a mean follow up of 15.5 +/- 6.6 months, resu lts were in agreement with data reported in the literature. perforatio n of the uterus < 5%, hemorrhage < 1%, metabolic syndrome < 2%. Patien ts were entirely satisfied in 58% of the cases but secondary hysterect omy was required in 14%. Precise indications: Despite the advantages o ver hysterectomy, endometrial resection should be reserved for selecte d patients in order to avoid an unsatisfactory high rate of failure.