Hysteroscopic management of intractable uterine bleeding. A review of 103 cases.

One hundred three patients with intractable uterine bleeding were treated using the continuous flow resectoscope. All patients underwent diagnostic hysteroscopy and endometrial sampling prior to surgery. The patients were divided into three groups. Group I (n = 69) patients had a normal hysteroscopic examination. Group II (n = 26) had intrauterine pathology visible on their diagnostic hysteroscopy. Group III (n = 8) had failed to improve satisfactorily on previous hysteroscopic ablation of the endometrium using the Nd:YAG laser. Group I and III patients underwent hysteroscopic ablation of the endometrium using a 3-mm, ball-end electrode. Group II patients underwent hysteroscopic resection of an intra-uterine lesion utilizing a 7-mm wipe loop electrode. The results in all three groups were analyzed and compared. Seventy patients underwent endometrial preparation with one of five pretreatment regimens: danazol, depoleuprolide, depomedroxyprogesterone acetate and surgery.