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).
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