L Rankin1, L H Steinberg. 1. Department of Obstetrics and Gynaecology, St John's Hospital, Chelmsford, Essex, UK.
Abstract
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.
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. Glycinetoxicity 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.