Endometrial resection in Oxford: The first 500 cases—a 5 year follow up

Abstract

SummaryTranscervical resection of endometrium is a new surgical technique for the treatment of menorrhagia. This study was undertaken to determine the long term success of the procedure and assess factors associated with a successful outcome. An audit of the case notes of the first 500 women undergoing this operation in Oxford between July 1988 and July 1992 was undertaken. Patients who had not subsequently undergone hysterectomy following the procedure were contacted by postal questionnaire in July 1993 to determine their menstrual details and their subjective assessment of success or failure of the operation.Twenty-three women (5 per cent) were lost to follow up. Of the remainder 296 (62 per cent) were pleased or very pleased with the outcome, 80 women (17 per cent) were disappointed, and 102 (21 per cent) had subsequently had a hysterectomy. Amenorrhoea was achieved in 28 per cent of the women who did not have a hysterectomy. Failure of the procedure was more common when the operation was performed on women under the age of 40 years, or by surgeons who had performed fewer than 10 previous operations, or if performed during the luteal phase of the menstrual cycle or in the presence of intramural fibroids.The long term success of endometrial resection is lower than that suggested by previous short term follow up studies. If the operation is performed by experienced surgeons on women over the age of 40 years during the proliferative phase of the menstrual cycle, then long term success can be anticipated in approximately two-thirds of women.