Intrauterine Surgery Using Electrocautery

EDITORIAL COMMENT: This is a preliminary report. The authors informed the editor that they have treated 40 patients with this method. We will await the results of follow‐up and details of case selection. Endometrial ablation has been reported recently from several centres but authors have stressed that the procedure was not an alternative to hysterectomy except when the patient refused hysterectomy or was too ill for general anaesthesia (e.g. menorrhagia associated with coagulopathy due to neoplasia)—caution has been expressed because of the possibility that subsequent development of endometrial carcinoma may present late if cervical stenosis prevents tell‐tale vaginal bleeding; there is also the possibility of infection, or haematometra if endometrial ablation is incomplete. Many women would prefer to avoid hysterectomy when indicated by benign disease, but the operation has a relatively low mortality and morbidity, and endometrial ablation must be shown to do better. Is the retained cervix of coital value?—this has not, in the editor's opinion, been properly evaluated in follow‐up of premenopausal women having hysterectomy without oophorectomy. The answer to this question is relevant when counselling the patient about conservative methods of treatment aimed at avoiding hysterectomy. ABSTRACT A procedure is described which may considerably reduce the number of hysterectomies performed for abnormal uterine bleeding due to benign conditions.