Transcervical endometrial resection: is it really a simple solution for a major problem?

ABSTRACT Objectives To determine the long‐term efficacy of transcervical resection of the endometrium (TCRE). Design Prospective long‐term follow‐up study. Setting Academic practice tertiary care setting. Patients 116 concecutive women undergoing endometrial resection because of menorrhagia, who wished to retain the uterus. Intervention Hysteroscopic endometrial resection performed as a day procedure. Main outcome measures Long‐term assessment was on the basis of menstrual symptoms and patient satisfaction, and a questionnaire was used that included open‐ended and closed questions. Results 116 endometrial resections were carried out. The satisfaction rate varied from 75% to 70% over 5 years. At 1 year, 40% of women were amenorrhoeic. Larger uterine size, young age and adenomyosis were factors associated with negative outcomes. After initial TCRE, 20 women required further surgery, menorrhagia being the most common indication. Conclusion Although the use of TCRE to treat menorrhagia did not avoid the need for hysterectomy in all women, for those considering hysterectomy, it was an alternative procedure that was conservative, had low morbidity and provided a good chance of avoiding the need for major surgery, especially when performed by an experienced surgeon to treat women over the age of 45.