Abstract
The aim of this study was to determine the effectiveness and safety of hysteroscopic endomyometrial resection in the treatment of menorrhagia in patients unfit for major surgery or general anesthesia. Twenty-one patients with major medical diseases, including patients with severe heart or vascular diseases and patients suffering from mental retardation or cerebral palsy, were treated between November 1990 and October 1994. A standard resectoscope was used, and the uterine cavity was distended with 2.2% glycine. The procedure was carried out under spinal anesthesia in 11 (52%) of the patients. Seventeen (85%) of 20 patients with follow-up (mean 17 months) reported amenorrhea or hypomenorrhea. Resection was repeated in 3 patients, 2 of whom had hematometra. One uterine perforation in the cervix dilatation phase occurred. During the surgery, no fluid overload and only a single hemorrhage in excess of 600 mL were reported. In conclusion, hysteroscopic endomyometrial resection appears to be a safe and effective alternative for high-risk patients with menorrhagia. (J GYNECOL SURG 11:221, 1995)
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