Hysteroscopic Endometrial Resection in the Management of Abnormal Uterine Bleeding Among Libyan Women

Abstract

Background: Abnormal uterine bleeding (AUB) is a major health problem and it is a substantial cause of ill health in women. Medical treatment has a high failure rate and adverse effects. There are few published data on hysteroscopic endometrial resection (HER) in the management of patients with AUB.
Objective: To investigate the efficacy and outcomes of hysteroscopic endometrial resection (HER) in patients with AUB.
Materials and Methods: A descriptive hospital - based study was carried out at the departments of Obstetrics and Gynecology, Misurata and Sirt, Libya, during the period from January 2009 to December 2013. Women with AUB were recruited in the study. All women had a detailed medical and obstetrical history, physical examination and the hysteroscopic endometrial ablation and were followed-up for success or failure of the procedure which was assessed via symptoms (bleeding).
Results: A total of 120 women with mean (SD) of age and parity of 42.3 (6.8) years and 3.8 (2.4), respectively were recruited in the study initially. Thirty (25%) of these women were lost of followup Therefore, only 70 women (50 with DUB, and 20 women with fibroids) were available for the final analysis. All women underwent hysteroscopic endometrial resection and 28 of them had hysteroscopic myomectomy. The success rate was 92.8% (65/70) after 2 years follow up. All the five women with failure of the procedure were younger (<40 years); had bleeding with dysmenorrhea, bigger uterine size, thicker endometrium (> 7 mm) and they had fibroids.
Conclusions: Endometrial resection is an effective procedure in the majority of women with AUB, especially in those over age of 40 and without an increase in uterine size and has no fibroids.

Keywords: Uterine bleeding, hysteroscopic, endometrial resection, Libya.