Hysteroscopic surgery in postmenopausal women.

Objective: To assess the efficacy of hysteroscopic surgery in postmenopausal women presenting with abnormal uterine bleeding.

Design: A retrospective audit of 102 patients.

Setting: The Department of Obstetrics and Gynecology B, La Conception Hospital, Marseilles, France.

Patients: One hundred and two women between the ages of 47-67 years with postmenopausal bleeding or bleeding related to hormone replacement therapy were evaluated by pelvic ultrasound and diagnostic hysteroscopy. A benign organic cause was noted in 87 cases (polyps in 51 and fibroids in 36.) Fifteen patients had no significant disease.

Interventions: Resection of polyps or fibroids, endometrial ablation.

Results: One hundred and seven procedures were performed on 102 patients. Major operative complications were rare and included one perforation and one case of glycine toxicity. Eighty-eight patients were satisfied with the results. Six patients were subsequently treated by hysterectomy. Six patients complained of recurrent abnormal bleeding.

Conclusions: This modality of treatment appears to be effective over the long term. The operative criteria should take the causes of bleeding and not just the age of the patient into account.