Endometrial resection for the treatment of menorrhagia

Background Endometrial resection is an alternative to hysterectomy in the treatment of women with menorrhagia, but it may not control the condition. We sought to evaluate the effectiveness of such resection. Methods We followed 525 consecutive women (mean age at initial surgery, 42 years) for up to five years after endometrial resection. The women were examined 6 to 12 weeks after the operation and were then sent yearly questionnaires seeking information about their condition. The mean duration of followup was 31 months. Thirty-seven women (86 percent of the 43 women available for five years of follow-up) were followed for the entire period. Results Endometrial resection was completed successfully in 95 percent of the women, with operative complications in 6 percent. Forty-eight women underwent subsequent resection. The yearly questionnaires indicated that 85 to 100 percent of the women (depending on the year of follow-up) had adequately controlled menorrhagia, 26 to 40 percent had amenorrhea, 71 to 80 percent reported either a lessening of menstrual pain or no pain, and 79 to 87 percent were satisfied with the results of their surgery. No further surgery was needed by 80 percent of the women, and only 9 percent underwent hysterectomy during the five years of follow-up, with 98 percent of those operations being performed in the first three postoperative years. Conclusions Endometrial resection is an effective alternative to hysterectomy in women with menorrhagia. (C) 1996, Massachusetts Medical Society.