Abstract
ABSTRACT
Our objective was to evaluate the long-term results of transcervical resection of the endometrium (TCRE) and to identify factors associated with success and failure of the technique in nonmenopausal women. This was an 8-year retrospective study at the Department of Gynecology, St-André hospital, Bordeaux, France. Two hundred three women with abnormal uterine bleeding resistant to progestin therapy were treated by TCRE, and 194 were followed up with questionnaires. The main outcome measures were women's satisfaction with treatment after 1–8 years follow-up and identification of factors influencing the outcome: age, weight, parity, endocrine ovarian dysfunction, duration of bleeding, hemoglobin rate, hysterometry, histologie examination of endomyometrial resected tissue, postoperative intrauterine adhesions, and onset of menopausal status. The crude success rate of TCRE in 194 women was 87.6%, 85.5% in 152 nonmenopausal women and 95.2% in 42 menopausal women. Kaplan Meier analysis showed a 75% success rate, 95% CI (58%–86%) to 7.5 years in the 194 women, a 71% success rate, 95% CI (52%–84%) to 7.5 years in the 152 nonmenopausal women (82% success rate to 5 years), and a 95% success rate, 95% CI (92%–99%) to 6.5 years in the 42 menopausal women. The onset of menopause (p Wald = 0.03) and the absence of endocrine ovarian dysfunction (p Wald = 0.08) protected initially nonmenopausal women against failure in the final bivariate Cox proportional hazard model. The other factors did not influence the outcome of TCRE. Our results suggest that TCRE is an alternative to hysterectomy in women close to menopause, say over 45 years, suffering from metromenorrhagia resistant to progestin therapy. (J GYNECOL SURG 13:57, 1997)
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