Impact of transcervical resection of endometrium on uterine and ovarian haemodynamics

This study prospectively evaluated the impact of transcervical resection of endometrium (TCRE) on uterine and ovarian haemodynamics. The study group comprised 35 women with abnormal (excessive) uterine bleeding who underwent TCRE. The patients were examined by transvaginal colour Doppler ultrasonography 1-4 days prior to operation, and then 1, 3, 6 and 12 months post-operatively, to measure resistance index (RI) and pulsatility index from uterine, arcuate, radial and ovarian arteries. Thirty-five patients were followed up for 1 year after TCRE. Thirty (85.7%) patients had adequately controlled menorrhagia as defined by the patients subjectively. Nine (25.7%) patients had amenorrhoea, 21 (60%) patients had hypomenorrhoea and five (14.3%) patients had lighter periods initially but the menorrhagia recurred within 1 year after the operation. However, patients who had relapse of menorrhagia at 1 year after TCRE had a lower RI at all levels of uterine arteries compared with those who had persistent improvement. The data suggest that patients who had TCRE per se did not have associated altered uterine and ovarian haemodynamics; however, compared with those who had persistent improvement, those who had relapse in symptoms had an associated lower RI (P < or = 0.01) after TCRE at all levels of uterine arteries.