Comparison of hysteroscopic endometrial resection and laparoscopic assisted vaginal hysterectomy for the treatment of menorrhagia

Background. To compare the advantages and disadvantages of the two endoscopic procedures, hysteroscopic endometrial resection and laparoscopic assisted vaginal hysterectomy (LAVH), in the treatment of menorrhagia. Methods. Forty women requiring surgical treatment for menorrhagia underwent LAVH. These women were compared retrospectively with forty women having had endometrial resection for menorrhagia. The operations were performed between November 1991 and February 1995. Results. Operating time, hospitalization and postoperative recovery were significantly shorter with endometrial resection than with LAVH. In the hysteroscopy group amenorrhea or hypomenorrhoea was achieved in 80% of cases. Hysterectomy was performed in two cases (5%). In the hysteroscopy group all but three women (92%) were satisfied with the procedure, in the LAVH group all but one (97%). Conclusions. In the surgical treatment of menorrhagia both procedures art effective. LAVH is associated with a longer recovery period, but if offers a permanent relief of menorrhagia. Even though endometrial resection does not render all women treated amenorrhoeic, the satisfaction rate during the follow-up period was high; it is a useful alternative with many shortterm benefits.