A review of 80 endometrial resections for menorrhagia.

OBJECTIVE: To assess the efficacy of endometrial resection in treating menorrhagia. DESIGN: A clinical audit of 80 consecutive patients. SETTING: The department of gynaecology, Ealing Hospital, London. SUBJECTS: Eighty women referred by their general practitioner with the primary complaint of menorrhagia. INTERVENTIONS: Endometrial resection by hysteroscopic electro-diathermy. MAIN OUTCOME MEASURES: Subjective assessment of the change in menstrual blood loss by the 75 patients, who were followed up for at least one year. RESULTS: Of 75 women assessed after 1 year 45 (60%) had a successful outcome and nine (12%) had 'some improvement'. There were 21 failures; 14 reported 'no improvement' initially and seven were late failures after a good result at 6 months. Fifteen underwent a second procedure with 83% success at 6 months. Complications included uterine perforation in three women, excessive glycine absorption in two, and two women had problems with haemorrhage. Four women came to hysterectomy. CONCLUSIONS: Endometrial resection is an effective treatment for menorrhagia. Improvements in operative technique and equipment gave better results and fewer complications in the second half of the series.

Bacteriological contamination during laparoscopy with dye injection.

Peritoneal contamination with bacteria during the laparoscopy and dye procedure was studied in 38 subfertile women by culturing samples of peritoneal fluid, aspirated before, and after, injection of dye solution. Bacteria were carried with the dye into a previously sterile peritoneal cavity in 34 women (90%). These vaginal organisms were present in low concentrations, not exceeding 10(5) organisms/ml. These findings explain the low incidence of acute salpingitis after tubal patency tests, but the selective use of antibiotic prophylaxis is recommended.