Clinical Study On Treatment Of Benign Pathological Changes Of Uterine Cavity By Hysteroscopy

Benign pathological changes are common in gynecology department, which consist of dysfunctional uterine bleeding (DUB), submucous myoma and endometrial polyp. They will do harm to women health and quality of life if they could not be treated correctly. The main symptom is abnormal uterine bleeding, including menorrhagia, irregular vaginal bleeding , prolonged menstrual period, contact bleeding, postmenopausal vaginal bleeding, vaginal discharge and so on. Hysteroscope is a new subject in the modern gynecological field which start the application of the endoscope in the gynecological clinic. Transcervical resection (TCR) is a new way to treat benign pathological changes of uterine cavity after the traditional transabdominal hysterectomy (TAH). TCR need to be developed further in our country which started in 1990s, but it is common in the developed countries. This article studies the comparation about the transcervical resection of endometrial (TCRE), transcervical resection of myoma (TCRM), transcervical resection of polyp (TCRP) and traditional TAH, mainly discusses the operational time, bleeding amount, the followup of TCR to comfirm the efficiency and feasibility of TCR on treatment of DUB, submucous myoma and endometrial polyp. OBJECTIVE to compare the clinical course, advantages and disadvantages of TCR and TAH to treat DUB, submuous myoma and endometrial polyp. To evaluate the effectivity and feasibility on the treatment of the benign pathological changes of uterine cavity by hysteroscopy.METHODS ninty-four patients who were treated by TCR or TAH separately in our gynecology department from July 2001 to March 2004 were analyzed retrospectively. Among them forty-eight cases were performed TCR for treating DUB, submucous myoma and endometrial polyp. In the mean time forty-six cases were performed TAH. RESULTS all the operations were finished smoothly, the operation mean time, bleeding amount, the postoperative stimulation of urethra, the average postoperative hospital-stay time of TCR are better than TAH's, all cases who were performed TCR recovered their bowel function within one day. There were obvious difference statistically. We follow-uped 48 patients who were performed TCR. Among them twenty-three cases who were in pausimenia (including perimenopausal period) cease their abnormal uterine bleeding in one and a half months without any compliant, eleven cases who were in vegetation period menstruate regularly in two months, fourteen cases reduce their menstruations greatly. All the cases are one hundred percent satisfied with the result of TCR's treatment. Six cases have menorrhalgia before TCR, after TCR five cases' symptom disappeared, one case complained less. The clinical curative rate for menorrhagia was eighty-three point three percent.CONCLUSIONS compared with TAH, TCR surgery was no incision, shorter of operating time, mini-invasive, less bleeding, 100% bowel function recovery within day, less stimulative symptom of urethra, lower postoperative morbidity, less antibiotics and fees of pharmacy percentage of pharmacy within total medical expenses and the total medical expenses of TCR, TCR almost has no severe complications,in the mean time it keeps the patient pregnancy ability and ovary function, the postoperative quality of life is improved. For many cases Hysteroscopy can take place of TAH, which should be the preferred treatment for the benign pathological changes of uterine cavity if the indication is well controlled.