[Endometrial resection in the treatment of persistent metrorrhagia].

STUDY OBJECTIVE: To evaluate the efficacy of hysteroscopic endometrial resection such us a surgical alternative to hysterectomy in treating abnormal uterine bleeding unresponsive to treatment with progestogens. METHODS: A retrospective analysis was carried out on 54 patients who underwent endometrial ablation for abnormal uterine bleeding unresponsive to conservative medical management between January 1, 1991, and December 31, 1998. The average patient was 43 years (Range: 36-57 years) and was followed for a mean of 37 months (range 12-80 months). RESULTS: 83.3% of women were satisfied during the study period. The overall amenorrhea rate was 29.62%. Only 16.66% of subjects reported no improvement. Histologic analysis of the endomyometrial specimens revealed hyperplasia in 48.1% of cases, atrophy in 3.7% of cases and adenomyosis in 44.6% of cases. 8 women (14.8%) needed secondary hysterectomy for continued symptoms during a mean follow up of 10 months. Adenomyosis was present in 4 specimens (50%), myomas in 3 specimens (37.5%), and the association in 1 specimen (12.5%). CONCLUSION: Endometrial ablation is a safe and effective hysteroscopic procedure for dysfunctional uterine bleeding, its prognosis depends of several factors, that shows the importance of patients selection.