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Long-term outcome of hysteroscopic endometrial resection with or without myomectomy in patients with menorrhagia

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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the long-term outcomes and hysterectomy rates after hysteroscopic endometrial resection with or without myomectomy for menorrhagia.

Study design

Fifty-three women who had submucous myomas with intramural extension of less than 50% and smaller than 5 cm in diameter underwent endometrial resection and concomitant hysteroscopic myomectomy. Each of them was matched with a patient who had no submucous myomas and who had been treated by endometrial resection only. These two groups were compared for operative outcomes, additional procedures, outcome of menstrual bleeding and for subsequent hysterectomy, which was the endpoint of this study.

Results

During the mean follow-up period of 6.5 years, 18 (34.6%) women with endometrial resection and myomectomy and 21 (39.6%) without myomectomy underwent at least one gynecological procedure. Hysterectomy was performed in 26.9% [95% confidence interval (CI) 16.8–40.3] of the patients with myomectomy and in 17.0% (95% CI 9.2–29.2) of the patients without myomectomy (P = 0.22). The main indications for hysterectomy were pain and spotting bleeding in seven out of 14 cases with myomectomy and in four out of nine with endometrial resection only. Leiomyomas were found in 12 out of the 14 women who had hysterectomy after hysteroscopic myomectomy and in four out of nine with hysterectomy after endometrial resection only (P = 0.06). Most (75.6%) of the 82 women who had not required hysterectomy had reached menopause. All the patients without hysterectomy in both groups reported amenorrhea or slight bleeding, and this response maintained for years after the treatment.

Conclusion

Endometrial resection may be combined with hysteroscopic myomectomy without a significant increase or decrease in hysterectomy rates during a long-term follow-up.

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Acknowledgments

This study was supported by grants from competitive research funding of the Pirkanmaa Hospital District, Tampere, Finland.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tampere University Hospital and Medical School, 33521, Tampere, Finland

    Päivi H. Rovio, Riikka Helin & Pentti K. Heinonen

Authors
  1. Päivi H. Rovio
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  2. Riikka Helin
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  3. Pentti K. Heinonen
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Correspondence to Päivi H. Rovio.

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Rovio, P.H., Helin, R. & Heinonen, P.K. Long-term outcome of hysteroscopic endometrial resection with or without myomectomy in patients with menorrhagia. Arch Gynecol Obstet 279, 159–163 (2009). https://doi.org/10.1007/s00404-008-0694-4

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  • DOI: https://doi.org/10.1007/s00404-008-0694-4

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