Hypermenorrhea: Surgical Therapy

1st order

  • Abrasio (histology) – scraping of the mucosa of the uterus so that it can then be examined histologically (fine tissue).
  • Surgical removal of fibroids (benign uterine growths) or polyps.
  • Endometrial ablation – gentle and low-complication removal of the endometrium for the treatment of excessive menstrual bleeding(s) when family planning has been completed.
    • First generation methods:
      • Snare resection
      • Roller ball
      • Yag laser
      • Microwave coagulation
    • Second generation methods:
      • Balloon catheter
      • Cryosurgical procedures
      • Hydrothermablation
      • Bipolar three-dimensional mesh (see below gold mesh method).
  • Hysterectomy/vasectomy (supracervical, total) – is indicated only after failure of endometrial ablation.

Further notes

  • In recent years, a non-surgical, outpatient therapy option with few side effects and gentle pain has emerged with the so-called MRI (magnetic resonance imaging) guided focused ultrasound therapy (MRgFUS) (synonym: MR-HIFU = Magnetic Resonance High Intensity Focused Ultrasound). For more information, see “Focused ultrasound (MR-HIFU) of fibroids“.