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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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standard)), [3] roller-ball endometrial ablation, [4] and endometrial laser ablation; these techniques have largely been replaced by the nonresectoscopic procedures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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