Authors:
Overton C. Hargreaves J. Maresh M.
Institution:
Dr. M. Maresh, The Clinical Audit Unit, Royal Coll.
Obstetricians Gynaecol., St Mary's Hosp. Women and Children,
Hathersage Road, Manchester M13 0JH; United Kingdom.
Title:
A national survey of the complications of endometrial destruction for menstrual disorders: The MISTLETOE study (1998-2077).
Source:
Contemporary Reviews in Obstetrics and Gynaecology. Vol 10(3) (pp09-216), 1998.
Abstract:
The MISTLETOE study was designed to investigate the Frequency of complications of endometrial resection and ablation for menstrual disturbances and the influence of the experience of the operators. It was a prospective survey with additional retrospective reporting by theatre staff in 300 NHS and independent hospitals in the UK (excluding Scotland). 10,686 women were registered by 690 doctors (1-222 cases/doctor) between April 1993 and October 1994. Two directly related deaths were reported. Laser and rollerball ablations were associated with least operative and postoperative complications. Combined loop and rollerball diathermy was associated with a higher rate, but with fewer immediate operative complications than loop resection alone. Endometrial thinning agents were not associated with decreased complications. Fibroids were associated with increased operative haemorrhage. Early postoperative complication rates ranged from 0.77 to 1.51%. Six-week follow-up in 82.5% of the women revealed few complications (1.25 to 4.58%). Increasing operative experience was associated with fewer uterine perforations in the loop resection alone group (chi2 for trend p< 0.001), but had no effect on operative haemorrhage in any group. These procedures were used widely in 1993-4 with low morbidity and mortality. The techniques may be relatively easily learned in the apprenticeship system without compromising safety. Combined diathermy resection appears safer than loop resection alone, but laser and rollerball ablation were safest.
Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
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