Endometrial resection versus vaginal hysterectomy for menorrhagia: Long-term clinical and quality-of-life outcomes☆,☆☆,★,★★
Section snippets
Material and methods
This randomized controlled trial compared hysteroscopic endometrial resection with vaginal hysterectomy in the treatment of menorrhagia. The investigation was performed in an academic department specializing in operative hysteroscopy. The trial protocol was approved by the ethics committee of the institution and the subjects gave informed consent to the study.
Women aged ≤50 years referred to a third-level outpatient clinic for menorrhagia not responding to medical treatment and requiring
Results
One hundred eighteen subjects evaluated in a menorrhagia outpatient clinic were considered eligible for the study, but 26 refused randomization. Forty-five of the remaining 92 patients were allocated to endometrial resection and 47 to vaginal hysterectomy. After randomization, 7 women withdrew from the study before surgery, 4 in the endometrial resection group (1 refused the allocated treatment, 1 underwent surgery in another hospital, 1 did not want further treatments, and 1 was lost to
Comment
The results of three randomized clinical trials comparing endometrial resection with hysterectomy have been published.3, 4, 5, 6, 12 In the study of Gannon et al.3 on 51 patients, no significant difference was observed in failure rate between the groups. Four (16%) of the 25 women allocated to operative hysteroscopy had a repeat resection for persistent menorrhagia after a mean follow-up of 12 months. In the Bristol trial4, 6 99 subjects were allocated to endometrial resection and 95 to
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Cited by (0)
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From the Clinica Ostetrica e Ginecologica “Luigi Mangiagalli,” Universitá di Milano,a and Laboratorio di Epidemiologia Clinica, Istituto di Richerche Farmacologiche “Mario Negri.”b
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Supported in part by Italian National Research Council (Rome) Applicazioni Cliniche della Ricerca Oncologica grant No. 94.01322.PF39.
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Reprint requests: Paolo Vercellini, MD, Clinica Ostetrica e Ginecologica “Luigi Mangiagalli,” Universitá di Milano, Via Commenda, 12-20122, Milano, Italy.
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