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TEMPLATE DESIGN © 2008 www.PosterPresentations.com Do we still need to resect ? A six year review and patient satisfaction survey Dr Uma Mahesha Arava,

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Presentation on theme: "TEMPLATE DESIGN © 2008 www.PosterPresentations.com Do we still need to resect ? A six year review and patient satisfaction survey Dr Uma Mahesha Arava,"— Presentation transcript:

1 TEMPLATE DESIGN © Do we still need to resect ? A six year review and patient satisfaction survey Dr Uma Mahesha Arava, Dr Dimitrios Koleskas, Dr Mark Roberts, Dr Tony Chalhoub Royal Victoria Infirmary, Queen Victoria Road, Newcastle, NE1 4LP, England Introduction Transcervical resection of fibroids(TCRF) has traditionally been used to hysteroscopically resect submucous fibroids that cause menstrual problems or that may be interfering with the ability to conceive has been combined with transcervical resection of the endometrium(TCRE) to treat menorrhagia. It has been considered the gold standard for the treatment of symptomatic submucous fibroids. 1 However with the advent of newer endometrial ablation techniques that are less user dependent, there seems to be a gradual reduction in the use of resection techniques with the potential for loss of skill among the newer generation gynaecologists. TCRF and TCRE is a core component of hysteroscopic surgery and training should be directed to achieve and maintain this key skill, lest it be consigned to history. Methods This was a prospective study over a six year period from evaluating the effectiveness of TCRE/F and a retrospective one year study assessing patient satisfaction rates. Data regarding resection was collected prospectively on an ongoing basis and information about satisfaction was obtained using a patient satisfaction questionnaire. 73 patients who underwent TCRF with or without TCRE were included of whom 49 patients responded with information regarding bleeding pattern and satisfaction. Results Conclusions References OPTIONAL LOGO HERE 1. Cravello L, Agostini A, Beerli M, Roger V, Bretelle F, Blanc B. Results of hysteroscopic myomectomy. Gynecol Obstet Fertil Sep: 32(9): Agdi M, Tulandi T. Endoscpic management of uterine fibroids. Best Prac Res Clin Obstet Gynaecol Mar 4. (Abstract). Objectives To evaluate the treatment effect of Transcervical resection of fibroid and Transcervical resection of endometrium at the Royal Victoria Infirmary, Newcastle and to assess patient satisfaction. endometrium(TCRE) at the Royal Victoria Infirmary, Newcastle and to assess patient satisfaction Results Menorrhagia was the commonest indication for the procedure. 65 (89%) of patients had submucous fibroids on pre-op ultrasound scan. The majority of submucous fibroids resected were grade 1 Most of the submucous fibroids measured 1-5 cms in size. Fluid overload of greater than 1 litre was the most frequent complication. Of the 49 women who were followed up at 1 year, 21 women had amenorrhoea and 23 women had light bleeding giving a success rate of 90%. success rate of 90%. Patient satisfaction was high at 90%. Transcervical resection of fibroids is an established surgical procedure for women with submucosal fibroids and excessive uterine bleeding, infertility or repeated miscarriages. 2 TCRM/E is an effective treatment for menorrhagia particularly in the presence of submucous fibroids and is associated with high levels of patient satisfaction. Efforts should be made to provide continous training in acquiring and maintaining resection techniques to prevent loss of skill particularly in the backdrop of emerging ablation techniques.


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