The effect of increasing age on the outcome of hysteroscopic endometrial resection for management of dysfunctional uterine bleeding.

STUDY OBJECTIVE

To determine the outcome of hysteroscopic endometrial resection for dysfunctional uterine bleeding according to women's age.

DESIGN

Long-term follow-up by telephone interview (Canadian Task Force classification II-2).

SETTING

University-affiliated medical center. Patients. One hundred sixty-nine women with abnormal uterine bleeding unresponsive to conservative medical management.

INTERVENTION

Hysteroscopic endometrial resection.

MEASUREMENTS AND MAIN RESULTS

Questionnaires were completed for 162 (95.9%) patients with mean +/- SD follow-up of 32 +/- 17 months. The frequency of postoperative complications was not related to age. After ablation, the rate of amenorrhea was significantly higher in 31 women age 50 years or older than in younger women (p <0.001), and also in 72 women age 45 to 49 than in 59 age 44 or less (p <0.05). Complete relief of dysmenorrhea was achieved significantly more often in women age 45 to 49 (p <0.005) and 50 or older (p <0.05) than in those age 44 or younger. Dissatisfaction with the outcome of endometrial resection was uncommon, but most frequent among women age 44 or younger (p <0.10). There was no difference in the proportion of women requiring second ablation or hysterectomy in any age group.

CONCLUSION

Significantly higher rates of amenorrhea and complete relief of dysmenorrhea after endometrial resection are achieved in older than in younger women.