The gynecologic resectoscope, recently approved by the Food and Drug Administration for the treatment of abnormal
uterine bleeding, was evaluated for its success in the treatment of women with this complaint. Through June 1990, 216 patients were treated with this modality. Ninety were treated with transcervical
myomectomy alone since they still desired fertility preservation or wished to avoid
hysterectomy. Of the patients treated, 189 (87.5%) had follow-up evaluation for at least three months and some as long as three years. Of the ninety patients treated with resection of a submucous
myoma, greater than 90% had a marked improvement in their symptoms, with decreased menstrual
bleeding. Of the 96 patients treated with
endometrial ablation, 50% were amenorrheic, 26% had
hypomenorrhea, 17% had eumenorrhea, and 7% were unimproved. There was only one case of fluid overload, and no patients required a
blood transfusion. Complications included two cases of
endometritis and one perforation at the time of retrieval of
myoma fragments. Four patients required placement of a 30-mL Foley
catheter for control of postoperative
bleeding. Gynecologic resectoscopy is a safe and effective alternative to major surgery in the management of abnormal
uterine bleeding for which conservative measures have not been effective.