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.