Incidence cumulative d’hystérectomies chez les femmes ayant subi une résection hystéroscopique de l’endomètre

Abstract

Objective: to measure the cumulative failure rate following a hysteroscopic endometrial ablation for menorrhagia, and assess the satisfaction level of the treated women who did not require hysterectomy within five years of their initial endometrial ablation.Methods: retrospective study of 218 patients in whom endometrial ablation was performed by five gynaecologists at the Centre Hospitalier affilié Universitaire-de Québec—Pavillon St-Sacrement, between 1991 and 1997. The information was documented by phone interview and by chart review in 188 women.Results: the cumulative failure rates, assessed by the need to perform a hysterectomy after one, two, three, four and five years were 5.9, 8.3, 12.3, 17.5 and 18.5 percent, respectively. The satisfaction level in 157 women who did not require a hysterectomy was 86.6 percent. Among studied factors (age, parity, previous hormonal treatment, gynaecologist, indication for endometrial ablation, pathological findings and surgical complications), age was the only variable which was significantly associated with the risk of subsequent hysterectomy. The cumulative incidences of hysterectomy at 60 months were 53.5 and 11.6 percent in women below and above the age of 35 years, respectively.Conclusion: hysteroscopic endometrial ablation is an effective treatment for menorrhagia. This study allows the clinician to inform patients better about the relative success rate of this procedure, according to their age.