BMJ 1995;310:802 (25 March)

Letters

Laparoscopic hysterectomy is an alternative

DITOR,--We question S B Pinion and colleagues' recommendation for hysteroscopic endometrial ablation in dysfunctional uterine bleeding and believe that laparoscopic hysterectomy is an alternative with a high likelihood of success.1 In the analysis of their results the authors disregard the fact that 17 of the 96 women studied underwent hysterectomy within the 12 months of follow up. Another 11 required additional hysteroscopic treatment. These outcomes call into question the advantage of the "shorter recovery period" for the hysteroscopic procedure compared with hysterectomy.

In addition, 15% of the patients experienced the same or increased dysmenorrhoea at follow up, 22% had irregular periods, and 7% had bleeding lasting longer than seven days. The claim of 70-90% satisfaction among the women who underwent hysteroscopic treatment must be regarded as high. Although the outcome in patients who received both hysteroscopic ablation and subsequent hysterectomy is not analysed separately, these patients' satisfaction is more likely . . . [Full text of this article]


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