Hysteroscopic Endometrial Resection

Hysteroscopic endometrial resection is a surgical procedure used to treat abnormal uterine bleeding, particularly heavy menstrual bleeding, by removing the lining of the uterus (endometrium) using a hysteroscope.

Indications

• Abnormal uterine bleeding (AUB)
• Heavy menstrual bleeding (HMB)
• Menorrhagia
• Endometrial hyperplasia
• Submucous fibroids

Procedure

The procedure is typically performed under general anesthesia or local anesthesia with sedation. A hysteroscope, a thin, flexible tube with a camera and light on the end, is inserted through the cervix into the uterus.

A special instrument called a resectoscope is then used to remove the endometrial lining. The resectoscope uses electrical energy to cut and coagulate the tissue, which is then removed from the uterus.

Types of Resection

• Rollerball ablation: uses a rollerball electrode to destroy the endometrial lining
• Loop resection: uses a wire loop electrode to remove the endometrial lining
• Laser resection: uses a laser to vaporize the endometrial lining

Risks and Complications

• Uterine perforation
• Bleeding or hemorrhage
• Infection
• Adhesions or scarring
• Damage to surrounding organs

Benefits

• Reduced menstrual bleeding
• Improved quality of life
• Minimally invasive procedure
• Short recovery time
• Avoidance of hysterectomy in some cases

Post-Operative Care

Patients typically experience cramping, bleeding, and discharge after the procedure. They are advised to rest, use pain medication as needed, and avoid heavy lifting, bending, or strenuous activities for several days.

Follow-Up

A follow-up appointment is usually scheduled 1-2 weeks after the procedure to check for any complications and assess the patient's recovery. Additional follow-up appointments may be necessary to monitor the patient's menstrual bleeding and overall health.

Frequently Asked Questions (FAQs)

What is Hysteroscopic endometrial resection?
A surgical procedure to remove lining of the uterus using a hysteroscope.

Why is Hysteroscopic endometrial resection performed?
To treat abnormal uterine bleeding, particularly heavy menstrual bleeding.

How is the procedure typically done?
Under general anesthesia or local anesthesia, with a hysteroscope inserted through the cervix.

What are the benefits of Hysteroscopic endometrial resection?
Reduced bleeding, improved quality of life, and potentially avoiding hysterectomy.

Are there risks associated with the procedure?
Possible risks include infection, bleeding, and uterine perforation, among others.

How long does the procedure typically take?
Usually around 30-60 minutes, depending on individual circumstances.

What is the typical recovery time after the procedure?
Most women can return to normal activities within a few days to a week.

Will I still be able to get pregnant after the procedure?
Possibly, but it may depend on individual factors and should be discussed with a doctor.

Are there alternative treatments available?
Yes, other options such as hormone therapy or hysterectomy may be considered.

Is Hysteroscopic endometrial resection suitable for all women with heavy menstrual bleeding?
Not necessarily, suitability depends on various factors including overall health and specific condition.