Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “MENORRHAGIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2001

Treatment of menorrhagia before hysterectomy in a district general hospital. A retrospective review.

Between March 1996 and March 1998 236 women had a hysterectomy at Tameside District General Hospital. Of these, women, the indication in 132 was idiopathic menorrhagia and their treatments before hysterectomy were reviewed. It was found that luteal phase progestogens were the drug treatment of choice for menorrhagia by the general practitioners (GPs) and hospital doctors (46% and 40.5%, respectively). Fifty-two (39%) of the women had no medical treatment before hysterectomy while 38 (29%) had only one type of drug treatment. The decision to perform a hysterectomy was taken at the first clinic visit in 40 (30%) of the women and in 77 (58%) of them by the second visit. Transcervical resection of the endometrium (TCRE) was tried in 11% of the women, while none had the levonorgestrel impregnated intrauterine system (Mirena IUS) fitted. Objective assessment of menstrual loss was not performed before treatment. Our data suggest an early recourse to hysterectomy in the treatment of idiopathic menorrhagia and the hypothesis that hysterectomy follows failure of appropriate medical and alternative treatment of menorrhagia was not confirmed.

Journal Article↗
PubMed1996

Contemporary Concepts in Managing Menorrhagia.

Menorrhagia--technically defined as menses lasting longer than 7 days or a blood loss volume in excess of 60 to 80 mL--is one of the most common gynecologic complaints. It has been reported that 15% to 20% of otherwise healthy women experience debilitating menorrhagia. In the past, definitive treatment for abnormal uterine bleeding has been either abdominal or vaginal hysterectomy. Alternatives to hysterectomy are now stressed in light of the fact that nearly 50% of uterine specimens obtained during hysterectomies for menorrhagia are disease-free on pathologic examination. Etiologies are generally either endocrinologic or organic. Among the organic causes are coagulation disorders; organ dysfunction, such as liver or renal disease; endometrial hyperplasia; infection; iatrogenic causes, such as chemotherapy, anticoagulants, steroid therapy, and use of IUD; and anatomic causes, which include uterine leiomyoma, endometrial polyps, and pregnancy. Besides the history and physical exam, useful lab tests include CBC, serum pregnancy test, cervical specimens for gonorrhea and chlamydia, Pap smear, thyroid function tests, serum transaminases, luteinizing hormone, follicle-stimulating hormone, estradiol, prothrombin time, activated partial thromboplastin time, bleeding time, serum prolactin, quantitative beta human chorionic gonadotropin, blood urea nitrogen, serum creatinine, and adrenal function tests. Since many lesions are missed in office sampling or dilation and curettage, imaging studies, including ultrasound and hysteroscopy, can be useful in diagnosing the cause of menorrhagia. Medical treatments include drugs such as NSAIDS, progestins, oral contraceptives, and gonadotropin-releasing hormone agonists. Surgical modalities range from the relatively simple, such as D & C, to major surgical procedures such as hysterectomy. Laser ablation and thermal balloon ablation are promising new procedures.

Journal Article↗
PubMed1995

Assessment of patients with menorrhagia: how valid is a structured clinical history as a measure of health status?

A patient-administered questionnaire for menorrhagia based on the type of questions asked when taking a gynaecological history was developed and tested using the following steps: literature reviews, devising the questions, testing responses for internal consistency and test-retest reliability and validating the questionnaire by comparing patient's scores with their responses to the SF-36 general health measure, and with family practitioner perceptions of severity. The main sample consisted of 351 women with menorrhagia, 246 referred to gynaecology ambulatory clinics and 105 from four large training practices in North-east Scotland. Following testing, two questions were discarded from the questionnaire. The final questionnaire demonstrated a good level of reliability and the resulting patient scores correlated significantly with their scores on the scales making up the general health measure. The questions asked in taking a clinical history from a woman with menorrhagia can be used to construct a valid and reliable measure of health status. This clinical measure may be a useful guide in selection for treatment and in the assessment of patient outcome following treatment.

Adolescent↗
PubMed2002

Hematological abnormalities in adolescent menorrhagia.

BACKGROUND: The purpose of this study is to determine the frequency of underlying hematological disorders as the cause of acute adolescent menorrhagia. METHODS: The records of 25 patients that were hospitalized with acute adolescent menorrhagia in the Obstetrics and Gynecology Department of Cerrahpaşa Medical School of Istanbul University between 1988 and 1995 were analyzed. RESULTS: The mean age of the patients was 13.9 +/- 1.6 (SD) years. A hematological abnormality that caused bleeding diathesis and acute menorrhagia was diagnosed in 7 of the 25 patients (28%). There were four cases of immune thrombocytopenic purpura, two cases of Van Willebrand disease and one case of acute promyelocytic leukemia. All seven patients with a coagulation disorder required blood transfusions and the mean hemoglobin level at presentation was 6.2 g/dl.

Adolescent↗
PubMed1986

Endocrine consequences of danazol treatment in menorrhagia.

In order to study the endocrine side-effects of danazol, 15 patients with severe, benign menorrhagias, were individually treated with this drug to stop bleeding. LH, FSH, testosterone, free testosterone, DES-S, androstenedione, prolactin, estradiol and cortisol serum concentrations were measured before and after the 3 month treatment period. Danazol was found to be effective in reducing the amount of bleeding in patients with benign, severe menorrhagias; however, the weight gain of patients was significant during the 3 month period. LH and estradiol concentrations decreased; testosterone, free testosterone and dehydroepiandrosterone sulfate increased; prolactin, FSH, androstenedione and cortisol serum concentrations did not change, and SHBG disappeared from the serum, during the treatment period. We are of the opinion that danazol is an effective drug in menorrhagias with side-effects. In our view the hyperandrogenicity is the most important side-effect of this substance, which might be the result of some metabolites, but which might be the effect of a peripheral action of the drug as well.

Adult↗
PubMed1995

Hysteroscopic endomyometrial resection for the treatment of menorrhagia--follow-up of 86 cases.

OBJECTIVE: The aim of the study was to determine the effectiveness of hysteroscopic endomyometrial resection in the treatment of menorrhagia. STUDY DESIGN: Eighty-six women with menorrhagia underwent hysteroscopic endomyometrial resection between November 1990 and November 1993. The surgery was carried out under spinal anesthesia in 54 (64%) of the patients. A standard resectoscope was used and the uterine cavity distended with 2.2% glycine. The mean follow-up period was 22 months (range 4-39). RESULTS: No major complications occurred and no fluid overload was reported. One episode of uterine perforation, one of pelvic infection, five episodes of postspinal headache and four of hematometra were recorded. Hysterectomy was performed in five cases. Follow-up information was available on 79 (92%) patients. Amenorrhea was achieved in 20 (25%) patients and hypomenorrhea in 44 (56%) patients. Only three (4%) patients showed no improvement in menstrual flow. CONCLUSIONS: Hysteroscopic endomyometrial resection is a safe and effective mode of treatment for menorrhagia in selected patients.

Adolescent↗
PubMed2006

Managing drug-resistant essential menorrhagia without hysterectomy.

Menorrhagia is a common disorder that requires plenty of resources. Rapid developments in medical technology have resulted in new management strategies, which are true alternatives to hysterectomy. In many countries the levonorgestrel-releasing intrauterine system (LNG-IUS) and endometrial destruction techniques are available for menorrhagia. Clinicians must answer questions about cost, effectiveness and quality of medical care when choosing the treatment option. This review integrates the results from the latest studies and review articles about LNG-IUS and endometrial destruction techniques by addressing the key clinical issues in menorrhagia. Both LNG-IUS and endometrial ablation seem to be good and effective alternative options to hysterectomy. Although these treatments have relatively high failure rates, the majority of women are satisfied and the cost-effectiveness of these treatments are better than that of hysterectomy. Both treatments have their advantages and disadvantages. Thus far LNG-IUS seems to be more cost-effective than endometrial resection or hysterectomy at 5 years follow-up. However, second generation ablation techniques may offer better cost-effectiveness than the first generation techniques, but the evidence is insufficient.

Catheter Ablation↗
PubMed2004

Assessment of menstrual blood loss in women with ideopathic menorrhagia using the frameless levonorgestrel-releasing intrauterine system.

OBJECTIVE: This study was conducted to evaluate the effect of a "low-dose" levonorgestrel (LNG)-releasing intrauterine system (IUS) on the amount of menstrual blood loss (MBL) in women with ideopathic menorrhagia. METHODS: Menstrual blood loss was assessed with the visual assessment technique in 12 Belgian FibroPlant-LNG users with menorrhagia. In addition, ferritin levels were measured. RESULTS: The median MBL, evaluated by the visual scoring technique, decreased by more than 90%. The ferritin levels increased significantly during treatment with the levonorgestrel system. CONCLUSION: This study confirms previous MBL studies conducted with the FibroPlant-LNG IUS demonstrating the efficacy of the LNG-IUS to significantly reduce the amount of MBL in women with menorrhagia. The strong endometrial suppression is the principal mechanism explaining the effect on MBL. The therapeutic effect of this contraceptive method is highly desirable, particularly in women with heavy bleeding or anemia, as other treatment modalities are less effective, more costly, more invasive or inaccessible. The simple design characteristics and anchoring system account for minimizing the occurrence of complaints of pain and expulsion.

Female↗
PubMed2005

Transcervical endometrial resection in women with menorrhagia: long-term follow-up.

OBJECTIVE: Hysteroscopic endometrial resection is an innovative and conservative surgical technique considered, very often, as an alternative to hysterectomy. The aim of the study was to evaluate long-term efficacy of endometrial resection performed in women with menorrhagia. STUDY DESIGN: Retrospective study of 111 premenopausal women with menorrhagia, unresponsive to medical treatment, who underwent endometrial resection by resectohysteroscope (electrocautery technique supplied with a fundus rollerball electrode, with corneal areas, and with a 90 degrees loop for intrauterine walls and used with glycine 1% as distending fluid) between 1994 and 1999. RESULTS: Long-term follow-up questionnaires were completed in 106 cases, while 5 cases dropped-out (4.5%). The mean-age at menopause in our subjects was 52.8 years (17.6+/-18.4 months after operation). After 53.2+/-16.4 months, 82 patients (77.4%) showed a normal menstrual pattern or amenorrhea, while failure was recorded in 24 patients (22.6%) and 12/24 patients underwent hysterectomy. Percentage of success in the older population (>49 years) (94%) was significantly higher than in the younger population (70%). The histologic finding of only fibrosis (41.7%) correlated with failure of the technique. CONCLUSION: Our data suggest that endometrial resection by resectohysteroscope is an innovative and conservative but not exclusive surgical technique in selected younger women, while in older women endometrial resection nearly always resolves long-term menorrhagia.

Adult↗
PubMed1999

Partial rollerball endometrial ablation: a modification of total ablation to treat menorrhagia without causing complications from intrauterine adhesions.

OBJECTIVE: Our purpose was to demonstrate that intrauterine adhesions and hematometra do not occur after a partial rollerball endometrial ablation and that menorrhagia can be successfully treated by this procedure for patients without deep adenomyosis. STUDY DESIGN: Fifty patients with hysteroscopically normal-appearing cavities (without gross polyps or submucous fibroid tumors) had a partial endometrial ablation for menorrhagia and were followed up for >3 years. A partial ablation is defined as ablation of only the anterior or posterior endometrial wall and avoidance of the cornual areas. A posterior myometrial biopsy to determine the depth of adenomyosis was performed and correlated with outcome. The intrauterine cavity was evaluated postoperatively for adhesions. RESULTS: Patients without deep adenomyosis had good outcome after partial ablation. No postoperative intrauterine adhesions were found. CONCLUSION: Partial endometrial ablation can successfully treat menorrhagia in patients without deep adenomyosis. It does not cause intrauterine adhesions, which may lead to hematometra and potentially delay the diagnosis of endometrial cancer.

Adult↗
PubMed1997

Treatment of adenomyosis-associated menorrhagia with a levonorgestrel-releasing intrauterine device.

OBJECTIVE: To evaluate the efficacy and tolerability of treatment with a levonorgestrel-releasing intrauterine device (IUD) in women affected by adenomyosis-associated menorrhagia. SETTING: Tertiary care center. DESIGN: Prospective, open, noncomparative study. PATIENT(S): Twenty-five women aged 38 to 45 years with recurrent menorrhagia associated with adenomyosis diagnosed at transvaginal ultrasonography participated in this study. INTERVENTION(S): An IUD releasing levonorgestel 20 mcg/day was inserted in each patient within 7 days of the start of menstrual flow. All of the patients were requested to compile a pictorial blood loss assessment chart each month. They underwent clinical and transvaginal ultrasound examinations 3, 6, and 12 months after IUD insertion. MAIN OUTCOME MEASURE(S): Menstrual pattern; serum hemoglobin, ferritin, and iron level changes. RESULT(S): One patient experienced IUD expulsion 2 months after device insertion and another requested removal of the IUD 4 months after insertion because of persistent irregular blood loss. Six months after IUD insertion, amenorrhea was observed in 2 patients and oligomenorrhea in another, spotting occurred occasionally in 7, and 13 had scanty but regular flow. One year of follow-up has been completed by the remaining 23 women: 2 with amenorrhea, 3 with oligomenorrhea, 2 with spotting, and 16 with regular flows. Significant increases in hemoglobin, hematocrit, and serum ferritin have been observed, but the lipid metabolism and clotting variables have remained unchanged. CONCLUSION(S): Our findings indicate that marked and safe relief from adenomyosis-associated menorrhagia can be obtained with the use of a levonorgestrel-releasing IUD.

Adult↗
PubMed2003

New surgical treatments for menorrhagia.

CONTEXT: Hysterectomy is a common and effective treatment for menorrhagia but is associated with substantial post-operative convalescence time and morbidity. In the early 1990s endometrial resection or ablation became a well-established day-case alternative for the surgical treatment of menorrhagia. Both endometrial resection and ablation require general anaesthesia, a high level of skill in hysteroscopic surgery, and can be long procedures. More recently, various new techniques have been developed that can be done in an outpatient setting under local anaesthesia and with a low risk of complications. The effectiveness of most new second-generation ablation technologies has not been confirmed in randomised trials and it is possible that these techniques will not prove to be as effective or as safe as originally thought. STARTING POINT: Massimiliano Pellicano and colleagues (Am J Obstet Gynecol 2002; 187: 545-50) compared a second-generation ablation technique, thermal destruction of the endometrium with a heated-water-filled silicone balloon with hysteroscopic endometrial resection. 82 women were randomised and followed up for 2 years. Thermal destruction was quicker than hysteroscopic resection, and was associated with a similar level of postoperative satisfaction and reintervention rate. This study suggests that thermal destruction is as effective a technique as endometrial resection. WHERE NEXT? Many second-generation ablation techniques are now available. Some may prove more effective than others, but much larger studies are needed to address safety. The development of progestagen-releasing intrauterine devices, which provide effective treatment for menorrhagia and are also an effective and reversible form of contraception, may mean that the uptake of second-generation surgical ablation techniques is less widespread than some proponents of these new technologies suggest.

Catheter Ablation↗
PubMed2000

Thermal balloon and rollerball ablation to treat menorrhagia: two-year results of a multicenter, prospective, randomized, clinical trial.

STUDY OBJECTIVE: To evaluate 2-year follow-up results in patients participating in a randomized, clinical trial comparing uterine balloon therapy with rollerball endometrial ablation. STUDY DESIGN: Prospective, randomized, clinical trial (Canadian Task Force classification I). SETTING: Fourteen university-affiliated and private practice sites. PATIENTS: Two hundred fifty-five women with menorrhagia. INTERVENTIONS: Patients were randomized to rollerball or uterine balloon endometrial ablation. MEASUREMENTS AND MAIN RESULTS: Patient satisfaction with both treatments was consistently high. Only 15 hysterectomies had been performed (6 for menorrhagia) at the end of 2 years, 11 in the rollerball group, 4 in the balloon therapy group. CONCLUSION: Endometrial ablation by both procedures was highly successful in avoiding hysterectomy and relieving symptoms of menorrhagia. Additional benefits were reduction in dysmenorrhea and premenstrual syndrome.

Adult↗
PubMed2004

Microwave endometrial ablation vs. rollerball electroablation for menorrhagia: a multicenter randomized trial.

STUDY OBJECTIVE: To compare the effectiveness, safety, and acceptability of microwave endometrial ablation (MEA) with those of rollerball electroablation (REA) for the treatment of menorrhagia. DESIGN: Randomized clinical trial (Canadian Task Force classification I). SETTING: Eight academic medical centers and private medical practices. PATIENTS: Three hundred twenty-two women with documented menorrhagia due to benign causes. INTERVENTION: MEA or REA. MEASUREMENTS AND MAIN RESULTS: By intent-to-treat analysis, the success rate of MEA at 12 months (87.0%; CI 81.7%-91.2%) did not differ significantly (p = .40) from that of REA (83.2%; CI 74.7%-89.7%). Among evaluable patients, success rate was also similar (p = .24) in the MEA (96.4%; CI 92.7%-98.5%) and REA (92.7%; CI 85.6%-97%) groups. The amenorrhea rate in evaluable patients after MEA was 61.3% (CI 54.1 %-68.2%). In patients with myomas, the success and amenorrhea rates in evaluable patients after MEA were 90.3% (CI 74.2%-98%) and 61.3% (CI 42.2%-78.2%), respectively. In evaluable patients with body mass index of 30 kg/m2 or greater, MEA success rate was 96.7% (CI 88.5%-99.6%) compared with 81.8% (CI 59.7%-94.8%) for REA (p = .042). The ablation procedure was performed under IV sedation in 62% of patients in the MEA group versus 18% of patients in the REA group (p <.001); whereas, general anesthesia was employed more often in patients undergoing REA (37% vs. 76%, p <.001). No major complications were encountered. Patient satisfaction with results of treatment was high (98.5% of the MEA and 99.0% of the REA group). CONCLUSIONS: Microwave endometrial ablation is an efficacious and safe procedure for the treatment of menorrhagia. Over half of patients treated with MEA achieve amenorrhea, and the procedure is suitable for women with myomas and irregular uterine cavities. The procedure is easily learned and can be performed rapidly, under IV sedation in most cases.

Adult↗
PubMed2003

The HydroThermAblator system for management of menorrhagia in women with submucous myomas: 12- to 20-month follow-up.

STUDY OBJECTIVE: To assess the safety and efficacy of the HydroThermAblator (HTA) system to treat patients with menorrhagia and submucous myomas up to 4 cm in diameter. DESIGN: Retrospective, multicenter, cohort study (Canadian Task Force classification II-2). SETTING: Two medical centers from a large, prepaid, multispecialty health maintenance organization. PATIENTS: Twenty-two women. INTERVENTION: HTA endometrial ablation. MEASUREMENTS AND MAIN RESULTS: The HTA circulates free-flowing, heated (90 degrees C) saline in the uterine cavity for 10 minutes under direct hysteroscopic control. All procedures were performed in the office under local anesthesia after premedication with oral anxiolytic and analgesic agents. At least 1 year after treatment (average follow-up 15.4 mo, range 12-20 mo), women were contacted regarding their menstrual history. Success was defined as no additional medical or surgical intervention. Amenorrhea was defined as no bleeding, eumenorrhea as normal periods, and oligomenorrhea as less than a normal period. Twelve patients (54%) reported complete amenorrhea; 7 were premenopausal (41% amenorrhea rate) and 5 were postmenopausal (100% amenorrhea rate). Five (23%) reported oligomenorrhea and three (14%) eumenorrhea, and were very satisfied with the result. The overall success rate was 91%. Of two failures (9%), one woman had a repeat HTA 13 months later for menorrhagia. The other had a repeat HTA for persistent spotting and sustained a false passage and small perforation before the procedure began. She elected to have a vaginal hysterectomy 1 month later. Although the results are not statistically significant, patients were extremely satisfied with the outcomes, and no serious complications were related to the device or its use for this indication. CONCLUSION: HTA is probably safe and effective in treating women with menorrhagia and submucous myomas up to 4 cm in diameter. It offers advantages over hysterectomy and electrosurgical resection since it is an office-based procedure, and significant advantages over other global ablation technologies that, by their design, are unable to treat significantly distorted uterine cavities.

Adult↗
PubMed2001

Three-year comparison of thermal balloon and rollerball ablation in treatment of menorrhagia.

STUDY OBJECTIVE: To compare uterine balloon therapy and hysteroscopic rollerball endometrial ablation with respect to efficacy and safety in treatment of menorrhagia. DESIGN: Multicenter, prospective, randomized study (Canadian Task Force classification I). SETTING: Fourteen North American university and private practice sites. PATIENTS: Women undergoing endometrial ablation for menorrhagia. INTERVENTION: Rollerball endometrial ablation or uterine balloon therapy. MEASUREMENTS AND MAIN RESULTS: Of 275 women randomized to one of these procedures, 255 were treated under the protocol and 214 were followed for 3 years. Results of uterine balloon therapy and rollerball endometrial ablation remained similar, with little difference at 3 years compared with results at 1 year. We noted a suggestion of an increase in hysterectomies in the rollerball group (14) compared with the uterine balloon therapy group (8) at 3 years. CONCLUSION: Endometrial ablation with the ThermaChoice uterine balloon or rollerball continues at 3 years to be a successful method for treating menorrhagia, avoiding hysterectomy, decreasing dysmenorrhea and premenstrual symptoms, and improving quality of life. (J Am Assoc Gynecol Laparosc 8(1):48-54, 2001)

Adult↗
PubMed1995

Transcervical electrosurgical resection of submucous leiomyomas for chronic menorrhagia.

STUDY OBJECTIVE: To evaluate the effectiveness and safety of transcervical electrosurgical resection (TSR) of submucous leiomyomas with or without concomitant transcervical endomyometrial resection (TEMR) for chronic menorrhagia. DESIGN: Prospective observational study, with 6-month follow-up of all 208 women and up to 6-year follow-up of 185 (88.9%). SETTING: Gynecology departments of teaching, community, and proprietary hospitals. PATIENTS: Two hundred eight women with submucous leiomyoma requiring surgical treatment of menorrhagia between March 1988 and March 1994. INTERVENTIONS: All 208 women (age range 32-63 yrs) underwent TSR with a continuous-flow gynecologic resectoscope. In 88 of these women who had no desire to preserve fertility, concomitant TEMR was performed. MEASUREMENTS AND MAIN RESULTS: Six months postoperatively 113 (94.2%) of the 120 women who underwent only TSR reported normal menses and 85 (96.6%) had satisfactory results; 62 (70.5%) who had both TSR and TEMR were amenorrheic. Eleven (73%) of the 15 women who had TSR and wanted to conceive subsequently became pregnant. One hundred eighty-five (88.9%) of the 208 patients have been followed for as long as 6 years. Ninety (84.1%) of the 107 women who had only the initial TSR and 69 (88.5%) of the 78 who had initial TSR and TEMR had satisfactory results. Only five women (2.7%) required major abdominal surgery. Among those undergoing TSR and TEMR, 49 (62.8%) were amenorrheic for as long as 6 years after TSR and one or two TEMRs. Eight (3.8%) of the 208 women had perioperative complications: 6 (2.9%) had fluid overload, 1 (0.5%) had dilutional hyponatremia, and 1 (0.5%) had excessive postoperative bleeding requiring tamponade. CONCLUSIONS: We believe that TSR with or without concomitant TEMR is an effective and safe treatment for women with submucous leiomyomas suffering from chronic menorrhagia.

Abdomen↗
PubMed1998

Does transcervical resection of the endometrium for menorrhagia really avoid hysterectomy? Life table analysis of a large series.

STUDY OBJECTIVE: To determine long-term success and complication rates of transcervical resection of endometrium (TCRE) for menorrhagia. DESIGN: Retrospective audit of a continuous case series with a minimum of 2 and a maximum of 5 years' follow-up (Canadian Task Force classification II-2). SETTING: District general hospital and tertiary referral center for gynecologic endoscopy. PATIENTS: Three hundred eighty consecutive women with menorrhagia. INTERVENTION: TCRE performed as a day case or with overnight stay between August 1988 and December 1992. MEASUREMENTS AND MAIN RESULTS: Complications occurred in 6.8% of patients, with a perforation rate of 3.2%. Life table analysis showed a cumulative hysterectomy rate of 12.4% at 1 year, reaching a plateau of 27.4% after 4 years. The rate at 5 years was higher for women under age 45 years (35%) than for those 45 and over (14.9%, p <0.01, Mantel's test x(2)). Women whose operation was performed by a senior surgeon had a lower cumulative hysterectomy rate (12.6%) than those whose surgery was performed at least in part by trainees (38%, p <0.01, Mantel's text x(2)). There was no significant difference in cumulative hysterectomy rates between women who had uterine fibroids and those who did not. Ninety-six percent of hysterectomies were performed in the first 3 years after initial TCRE. CONCLUSION: Although TCRE for menorrhagia did not avoid hysterectomy in all women, for those considering hysterectomy, it was a conservative procedure with low morbidity and high chance of avoiding the need for major surgery, especially when performed in women over age 45, by an experienced surgeon.

Adult↗