advantages - no requirement for contraception post-procedure, risk of cervical and endometrial cancer is removed (if total hysterectomy undertaken)
disadvantages - operation is longer than with endometrial destruction techniques, hospital stay and return to work is longer than with endometrial destruction, risks of complications higher; also if subtotal hysterectomy is performed then the patient will still be at risk of cervical cancer and require cervical smears
endometrial destruction
these techniques are successful in reducing menstrual blood loss in the majority of women
in comparison with a hysterectomy - there is conservation of the uterus, there is a smaller risk of complications, operating time is shorter, there is a shorter hospital stay and the patient returns to work sooner (1)
disadvantages include:
in a few women, endometrial destruction will not result in less bleeding and women will require repeat treatments (or may require a hysterectomy)
endometrial destruction procedures carry a small risk of uterine perforation - this may then lead to an emergency hysterectomy (1)
the patient requires contraception (pregnancy is not advised after endometrial destruction); also there remains the risks of cervical cancer and endometrial cancer
Reference:
(1) Drug and Therapeutics Bulletin (2000), 38 (10), 77-80.
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