Transcervical resection of the endometrium: a review of 400 consecutive patients.

OBJECTIVE

To assess the efficacy of transcervical resection of the endometrium (TCRE) in women presenting with menstrual disorders.

DESIGN

A retrospective audit of 400 patients.

SETTING

The Department of Gynaecology, St John's Hospital, Chelmsford, Essex.

SUBJECTS

400 consecutive referrals with various bleeding disorders which were suitable for treatment with TCRE.

INTERVENTIONS

TCRE, either partially or completely.

MAIN OUTCOME MEASURES

Patient satisfaction with procedure at 4 months. The procedure was initially recorded as a failure if any further therapy was required but satisfaction after a second procedure was assessed.

RESULTS

432 procedures were performed in 400 women. Major operative complications were rare with two (0.46%) uterine perforations, four (0.93%) primary haemorrhages requiring Tamponade to control bleeding and one (0.23%) secondary haemorrhage requiring hysterectomy to control it. Glycine toxicity was not clinically apparent. 85% were satisfied after the initial TCRE and 92% were satisfied if the procedure was repeated.

CONCLUSION

TCRE is an advance in the management of menstrual disorders. Extensive training is required to minimise complications. The lack of long term follow-up is its major deficiency but this will be rectified in the future.