Transcervical resection of the endometrium and myometrium: a review of 111 patients after 6 years

Abstract

Objective To determine the medium- to long-term amenorrhoea rate and patient satisfaction following transcervical resection of both the endometrium and inner myometrium (TCREM). Design A prospective audit of 111 patients. Subjects 111 patients referred with menorrhagia, and concomitant dysmenorrhoea in 74% of cases. Setting Queen Charlotte's and Chelsea Hospital for Women, London. Methods Data relating to patient history, operational details, subsequent bleeding and pain, satisfaction and complications, were obtained from a pro forma, case notes and an annual questionnaire with a menstrual calendar. The patients were followed up for six full years. Results 103 women (93%) completed the audit. By the sixth year of follow up 78% of the women were satisfied with the result of their TCREM, 64% being amenorrhoeic. Conclusion Resection of both the endometrium and inner myometrium appears to offer an improved amenorrhoea rate compared with resection of the endometrium alone. Patient satisfaction is high and there was no apparent increase in morbidity. This applied to women with both menorrhagia and dysmenorrhoea.