1st order
- Abrasio – scraping of the mucosa of the uterus for histologic examination.
- Surgical removal of fibroids (benign tumors) or polyps (mucosal outpouchings of the endometrium).
- Gold net method (endometrial ablation) – gentle and low-complication removal of the endometrium for the treatment of excessive menstrual bleeding(s) with completed family planning; treatment success (symptom relief and no need for further surgery) was achieved in 90.2% (high-risk group) and 95.7% (low-risk group) of patients.
- Hysterectomy due to menorrhagia – is indicated only after failure of endometrial ablation [guidelines: S3 guideline].
Further notes
- In a study of more than 600 patients, laparoscopic supracervical hysterectomy was shown to be more effective than endometrial ablation for the treatment of women with menorrhagia:
- Better quality of life in the laparoscopy group: 69% of patients scored a full 100 (on the menorrhagia mulit-attribute quality of life scale, MMAS) at 15 months after surgery versus 54% in the ablation group; the rate of complications showed little difference (5 vs. 4%)
