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Title: The scope of hysteroscopic surgery in the treatment of menorrhagia
Author: Bhattacharya, Siladitya
ISNI:       0000 0001 2424 7188
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 1996
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This thesis deals with the scope of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding, and in particular presents the results of a randomised controlled trial of endometrial laser ablation (ELA) versus transcervical resection of the endometrium (TCRE). In addition, the effects of prophylactic antibiotics during surgery are studied, and the results of a randomised comparison of two types of admission-discharge policies presented. The possible role of misoprostol in cervical priming prior to hysteroscopic surgery is explored. Finally, ultrasonographic findings are presented in a sub-set of women one year after endometrial ablation. Chapter 1 describes the historical background of hysteroscopy and analyses the mechanism of action of laser and electrodiathermy. Chapter 2 describes the subjects and methods used for the main randomised trial comparing ELA and TCRE. Chapter 3 presents the clinical, psychological and economic outcome of the randomised comparison of ELA and TCRE. Satisfaction rates, menstrual outcome, symptoms of pre-menstrual syndrome (PMS), re treatment rates and costs are evaluated. Chapter 4 describes the outcome of a randomised study of the incidence of bacteraemia following the use of prophylactic antibiotics during hysteroscopic surgery in a subset of women participating in the main trial. Chapter 5 examines the acceptability, efficacy and comparative costs of daycase versus overnight stage in a randomised group of women. Chapter 6 examines the effect of misoprostol on cervical resistance prior to transcervical resection of the endometrium, in the context of a randomised controlled trial. Chapter 7 compares bladder and ovarian function two years post-operatively in a group of women randomised to either hysterectomy or hysteroscopic surgery, as part of an earlier study. Chapter 8 describes transvaginal ultrasonographic findings one year after hysteroscopic surgery in a group of asymptomatic women.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Mensturation Medicine