What is the role of surgery in the treatment of menorrhagia?

Updated: Dec 20, 2018
  • Author: Julia A Shaw, MD, MBA, FACOG; Chief Editor: Michel E Rivlin, MD  more...
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Answer

Surgical management has been the standard of treatment in menorrhagia when the cause is organic or when medical therapy fails to alleviate symptoms. Options for surgical intervention include the following:

  • Dilatation and curettage: Used for diagnosis rather than treatment, typically in combination with hysteroscopy

  • Resectoscopic endometrial ablation: Includes transcervical resection of the endometrium (TCRE; criterion standard)), [3] roller-ball endometrial ablation, [4] and endometrial laser ablation; these techniques have largely been replaced by the nonresectoscopic procedures

  • Nonresectoscopic endometrial ablation: Includes thermal balloon therapy, [5, 6] heated free fluid [7] , cryoablation, [8] microwave endometrial ablation, [9] and radiofrequency (RF) ablation [8]

Procedures for surgical excision include the following:

  • Myomectomy [10]

  • Hysterectomy [11, 12]

See Treatment and Medication for more detail.


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