Resectoscopic Versus Office Chemical Endometrial Ablation: Cohort Study

Abstract

Background: Menorrhagia is menstrual bleeding that is heavy in amount or duration and that occurs at regular intervals.
Aim: To compare office chemical endometrial ablation using TCA compared to resectoscopic procedures, estimating cost effectiveness, and evaluating quality of life before and after the procedure.
Patients & methods: This retrospective cohort study was carried out on 80 patients aged > 35 years old, with dysfunctional uterine bleeding and were randomly subdivided into either group I (underwent chemical endometrial ablation by TCA or group II (resectoscopic endometrial ablation) during the period of March 2016 to March 2020.
Results: Majority of patients in each group had improved family care and were very satisfied with the treatment with no significant differences between both groups (p> 0.05). Majority of patients either had been cured with treatment acceptable or had acceptable improvement in symptoms. Treatment wasn't acceptable in only 5 (27.5%) patients of group I and 7 (17.5%) patients of group II with insignificant difference between both groups (p> 0.05). It was found that group I had significantly lower theater cost (28.50 ± 5.33 vs. 452.50 ± 50.57; p= 0.000) and total health service cost (61.00 ± 4.41 vs. 485.75 ± 52.28; p=0.000) in comparison to group II. Meanwhile, both groups were comparable as regard recovery cost (31.00 ± 4.41 vs. 33.25 ± 7.97; p= 0.12).
Conclusion: Tri-cloro-acitic acid (TCA) is a safe and efficient method for treating dysfunctional uterine bleeding, particularly in non-conception women, without hospital admission or increased morbidity.