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VOLUME 6 , ISSUE 1 ( January-June, 2018 ) > List of Articles

ORIGINAL ARTICLE

Analysis of the Effectiveness of Transcervical Resection of Endometrium in Women with Abnormal Uterine Bleeding: Follow-up of 5 Years

Priyankur Roy, Vineet Mishra, Khushali Gandhi, Shaheen Hokabaj

Keywords : Abnormal uterine bleeding, Amenorrhea, Hysterectomy, Transcervical resection of endometrium

Citation Information : Roy P, Mishra V, Gandhi K, Hokabaj S. Analysis of the Effectiveness of Transcervical Resection of Endometrium in Women with Abnormal Uterine Bleeding: Follow-up of 5 Years. J South Asian Feder Menopause Soc 2018; 6 (1):17-21.

DOI: 10.5005/jp-journals-10032-1128

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: Abnormal uterine bleeding (AUB) is a clinical entity with a significant impact on physical, social, economical, and material quality of life of women. The objective of this study is to evaluate the efficacy, change in menstrual pattern, and patient satisfaction after transcervical resection of endometrium (TCRE) in women with AUB. Study design: Fifty-five women who underwent TCRE at a tertiary care center over a period of 5 years from February 2012 to January 2017 were identified through computerized procedure coding. They were contacted either by telephone or by postcard communication. Nine women could not be contacted because of change in their address and telephone number and hence, excluded from the study. Forty-six women were included in the study. The main outcome measures were menstrual status, level of satisfaction with the procedure, and the need for repeat TCRE or hysterectomy. Results: The average age of the patients was 47.89 ± 4.68 years with the range of 38 to 57 years. Twenty-six women (56.5%) undergoing TCRE had comorbidities which made them high risk for hysterectomy. During hysteroscopy, structural abnormalities like fibroid were found in 5 (10.87%) women, cervical polyp in 1 (2.17%) woman, and endometrial polyp in 1 (2.17%) woman. In six women, intraoperative hemorrhage was controlled using uterine tamponade with the inflated balloon of a Foley\'s catheter, kept for 6 to 8 hours after surgery. Of the 36 patients who had pain as a significant symptom preoperatively, 35 (97.2%) experienced either minimal or no dysmenorrhea postoperatively. One woman developed hematometra after 2 months of TCRE, for which hysteroscopic-guided cervical dilatation and repeat TCRE was done. Eight (17.39%) women had undergone hysterectomy. Out of these 8 patients, 2 (75%) of the women underwent repeat TCRE before hysterectomy. A total of 38 (82.61%) women were rendered amenorrheic, 2 (4.35%) women had only slight staining every 2 to 3 months, while 6 (13.04%) women had no improvement in their bleeding status. All those 40 (86.9%) women, who had achieved amenorrhea or oligomenorrhea, had high rate of satisfaction. Conclusion: Transcervical resection of endometrium is a clinically effective and cost-effective alternative to medical management or hysterectomy in women with AUB in perimenopausal women. The cost-effectiveness, work performance, rapid convalescence, and improved quality of life provide TCRE a “distinct edge” over the definitive management-hysterectomy.


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