A randomised trial comparing endometrial resection and abdominal hysterectomy for the treatment of menorrhagia

M J Gannon, Gannon MJ, M. Gannon, Holt EM, E. M. Holt, Fairbank J, Jeremy Fairbank, J Fairbank, M Fitzgerald, Fitzgerald M, M A Milne, Milne MA, A M Crystal, A. Crystal, Crystal AM, J. O. Greenhalf, Greenhalf JO
BMJ (Clinical research ed.) · 1991 · vol. 303(6814) , pp. 1362–1364 · doi:10.1136/bmj.303.6814.1362 · PMID:1760601 · PMC1671634 · W2074927467
RCT OA: bronze CC0 ⤵ 36 in-corpus citations
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This randomized trial found endometrial resection to be a shorter, less expensive procedure with faster recovery than abdominal hysterectomy for menorrhagia, though some women required repeat procedures.

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Abstract

OBJECTIVE: To determine the advantages and disadvantages of endometrial resection and abdominal hysterectomy for the surgical treatment of women with menorrhagia. DESIGN: Randomised study of two treatment groups with a minimum follow up of nine months. SETTING: Royal Berkshire Hospital, Reading. SUBJECTS: 51 of 78 menorrhagic women without pelvic pathology who were on the waiting list for abdominal hysterectomy. TREATMENT: Endometrial resection or abdominal hysterectomy (according to randomisation). Endometrial resections were performed by an experienced hysteroscopic surgeon; hysterectomies were performed by two other gynaecological surgeons. MAIN OUTCOME MEASURES: Length of operating time, hospitalisation, recovery; cost of surgery; short term results of endometrial resection. RESULTS: Operating time was shorter for endometrial resection (median 30 (range 20-47) minutes) than for hysterectomy (50 (39-74) minutes). The hospital stay for endometrial resection (median 1 (range 1-3) days) was less than for hysterectomy (7 (5-12) days). Recovery after endometrial resection (median 16 (range 5-62) days) was shorter than after hysterectomy (58 (11-125) days). The cost was 407 pounds for endometrial resection and 1270 pounds for abdominal hysterectomy. Four women (16%) who did not have an acceptable improvement in symptoms after endometrial resection had repeat resections. No woman has required hysterectomy during a mean follow up of one year. CONCLUSION: For women with menorrhagia who have no pelvic pathology endometrial resection is a useful alternative to abdominal hysterectomy, with many short term benefits. Larger numbers and a longer follow up are needed to estimate the incidence of complications and the long term efficacy of endometrial resection.

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MeSH descriptors

Endometrium Hysterectomy Menorrhagia Adult Endometrium Female Health Care Costs Hospitalization Humans Hysterectomy Hysterectomy Length of Stay Menorrhagia Menorrhagia Middle Aged Postoperative Complications Postoperative Complications Time Factors

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