Hysteroscopic endomyometrial resection: a new technique for the treatment of menorrhagia.

Thirty-five patients with menorrhagia and a normal uterine cavity underwent hysteroscopic endomyometrial resection. None underwent any form of medical or surgical preparation of the endometrium. A standard gynecologic resectoscope was used to excise a minimum of 3 mm of endomyometrium from the entire uterine cavity. This depth was reduced to 2 mm at the tubal ostia. All patients were followed for 3-6 months. Twenty-one of the 25 patients (84%) who were followed at 6 months reported amenorrhea. The mean dysmenorrhea scores improved from 2.84 to 0.56 postoperatively. Seven of the 35 patients were diagnosed with adenomyosis. One woman was found to have adenomatous hyperplasia of the endometrium. Hysteroscopic endomyometrial resection is a highly effective method for the treatment of menorrhagia. This technique produces a very high rate of amenorrhea, provides a histologic specimen of the endomyometrium, and obviates the need for medical or surgical preparation of the endometrium.