Clear-cut goals of clinical management are primarily dependent upon attaining a correct etiologic diagnosis. The first step in the evaluation of the patients is to establish the location or source of bleeding. Uterine cause can be due to a systemic or a local cause or can be dysfunctional. Once the diagnosis is established, Attempts at controlling: this problem have ´included 13onnonal manipulation, therapeutic curettage and even radiation. with patients failing the traditional approaches to treat ultimately undergoing hysterectomy. According to Depai tLnent of Health and Human Service, in 1990 alone 591,000 hysterectomies were performed in the US. As many as half of these operations are dysfunctional uterine bleeding, defined excessive uterine bleeding with no organic causes. Therapeutic options incluide PG inhibitors, antifibrinolytic agents and hormonal treatment For women with menorrhagia refractory to medical treatment, endometrial ablation, performed as outpatient procedure with a Nd : Yag laser or by electrosurgical resection/coagulation, is a safe, effective alternative to hysterectomy. The long recovery process after hysterectomy and changing patient expectation have made physicians seek procedures that carry less morbidity, cost less but have consistently good results. The initial reports on the conseverative treatment of abnormal uterine bleeding with resection of intrauterine myoma was by Neuwirth in 1976: he used an old instrument, the urologic resectoscopy. The recently developed, gynecologic resectoscopy(or operative hysteroscopy) is continous flow device utilizing a standard 0° or 300 hysteroscopy inside a double-channeled sheath.
Gynecologic resectoscopy is a safe and effective tools in the management of abnormal uterine bleeding.
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