[Course of metrorrhagia after biopsy curettage of the endometrium in women in reproductive age ].

Authors working in the department of gynaecology and obstetrics in the university hospital of Caen with non-pregnant, non-menopausal women who were followed-up for at least 2 years after curettage have been able to carry out a retrospective study of 102 curettage and biopsies carried out either for diagnosis or to lessen bleeding in cases of metrorrhagia, menorrhagia or menometrorrhagia. Histology of the endometrium showed 40 cases of hyperplasia, 17 cases of polyps in the cavity of the uterus, 19 cases of atrophy, 6 cases of endometritis, 3 cases of atypical hyperplasia and 17 cases of normal endometrium. Hysterectomy was carried out in 22 cases because of recurrence of metrorrhagia. Anatomopathological examination of the operation specimens had shown iatrogenic atrophy of the mucosa in 13 cases (59%). The authors believe that this hypoplasia can be responsible for some recurrences and suggest that the state of the endometrium should be reassessed when metrorrhagia reappears in spite of well controlled treatment with progestagens. In the case of atrophy a cycle of oestrogens and progestagens should be started as it should be immediately after the curettage. The authors hope in this way to lessen the number of hysterectomies that have to be carried out because of failure of medical treatment.