transcervical resection of the endometrium

Last reviewed 01/2018

Transcervical resection of the endometrium is a method of endometrial ablation for treatment of menorrhagia. The uterus is distended with glycine fluid at constant pressure to permit resectoscopic visualisation of the target area.

A gonadorelin analogue may be given for a period of time before the procedure to facilitate endometrial thinning before resection.

Under video surveillance, a small wire electrocautery loop is used to excise the basal layer of the endometrium. There are notable risks to this technique: uterine perforation is more likely (1.6%) than with laser ablation (0.3%). There is also a greater tendency to haemorrhage.

Operating time, hospital stay - 1/2 days - and time to return to full activity - about 2 weeks - are all reduced relative to hysterectomy.

Endometrial destruction is only suitable for a woman who does not want a future pregnancy (2).

Reference:

• (1) Consumers' Association (1994). Surgical management of menorrhagia. Drug and Therapeutic Bulletin, 32 (9) ,70-2.
• (2) Consumers' Association (2000). Which operation for menorrhagia. Drug andTherapeutic Bulletin, 38 (10), 77-80.