{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:56:05Z","timestamp":1784584565350,"version":"3.55.0"},"reference-count":23,"publisher":"BMJ","issue":"6960","license":[{"start":{"date-parts":[[1994,10,15]],"date-time":"1994-10-15T00:00:00Z","timestamp":782179200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1994,8,9]]},"published-print":{"date-parts":[[1994,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To evaluate the effectiveness and safety of endometrial laser ablation and transcervical resection of the endometrium compared with hysterectomy in the surgical treatment of women with dysfunctional uterine bleeding.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Prospective randomised controlled trial.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    : Gynaecology department of a large teaching hospital.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects<\/jats:bold>\n                    : 204 women who would otherwise have been undergoing hysterectomy for menorrhagia were recruited between August 1990 and March 1992 and randomly allocated to hysterectomy (n=99) or conservative (hysteroscopic) surgery (transcervical resection (n=52) and laser ablation (n=53)).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures<\/jats:bold>\n                    : Operative complications, postoperative recovery, relief of menstrual and other symptoms, patient satisfaction with treatment after six and 12 months. Results - Women treated by hysteroscopic surgery had less early morbidity and a significantly shorter recovery period than those treated by hysterectomy (median time to full recovery 2-4 weeks v 2-3 months, P&lt;0.001). Twelve months later 17 women in the hysteroscopy group had had a hysterectomy, 11 for continuing symptoms; 11 women had had a repeat hysteroscopic procedure; 45 were amenorrhoeic or had only a brown discharge; and 35 had light periods. Dysmenorrhoea and premenstrual symptoms improved in most women in both groups. After 12 months 89% (79\/89) in the hysterectomy group and 78% (75\/96) in the hysteroscopy group were very satisfied with the effect of surgery (P&lt;0.05); 95% (85\/89) and 90% (86\/96) thought that there had been an acceptable improvement in symptoms, and 72% (64\/89) and 71% (68\/96) would recommend the same operation to others.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Hysteroscopic endometrial ablation was superior to hysterectomy in terms of operative complications and postoperative recovery. Satisfaction after hysterectomy was significantly higher, but between 70% and 90% of the women were satisfied with the outcome of hysteroscopic surgery. Hysteroscopic surgery can be recommended as an alternative to hysterectomy for dysfunctional uterine bleeding.\n                  <\/jats:p>","DOI":"10.1136\/bmj.309.6960.979","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:30:54Z","timestamp":1319743854000},"page":"979-983","source":"Crossref","is-referenced-by-count":231,"title":["Randomised trial of hysterectomy, endometrial laser ablation, and transcervical endometrial resection for dysfunctional uterine bleeding"],"prefix":"10.1136","volume":"309","author":[{"given":"S B","family":"Pinion","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D E","family":"Parkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D R","family":"Abramovich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Naji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I T","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H C","family":"Kitchener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1994,10,15]]},"reference":[{"key":"2025122311593589000_309.6960.979.1","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1111\/j.1471-0528.1991.tb13484.x","article-title":"Outcomes of referrals to gynaecology outpatient clinics for menstrual problems: an audit of general practice records.","volume":"98","author":"Coulter","year":"1991","journal-title":"Br J Obstet Gynaecol"},{"key":"2025122311593589000_309.6960.979.2","unstructured":"Teo PYK .Hysterectomy in Scotland 1961-84. Glasgow:University Department of Child Health and Obstetrics.1987."},{"key":"2025122311593589000_309.6960.979.3","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/0277-9536(88)90289-4","article-title":"Do British women undergo too many or too few hysterectomies?","volume":"27","author":"Coulter","year":"1988","journal-title":"Soc Sci Med"},{"key":"2025122311593589000_309.6960.979.4","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/0002-9378(73)90051-3","article-title":"The hospital care of patients undergoing hysterectomy: an anslysis of 12,026 patients from the professional activity study.","volume":"117","author":"Ledger","year":"1973","journal-title":"Am J Obstet Gynecol"},{"key":"2025122311593589000_309.6960.979.5","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/0002-9378(82)90362-3","article-title":"Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States.","volume":"144","author":"Dicker","year":"1982","journal-title":"Am J Obstet Gynecol"},{"key":"2025122311593589000_309.6960.979.6","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0002-9378(81)90251-9","article-title":"Laser photovaporisation of endometrium for the treatment of menorrhagia.","volume":"140","author":"Goldrath","year":"1981","journal-title":"Am J Obstet Gynecol"},{"key":"2025122311593589000_309.6960.979.7","first-page":"392","article-title":"Hysteroscopic management of intrauterine lesions and intractable uterine bleeding.","volume":"61","author":"DeCherney","year":"1983","journal-title":"Obstet Gynecol"},{"key":"2025122311593589000_309.6960.979.8","first-page":"7","article-title":"Endometrial ablation: a safe procedure.","volume":"1","author":"MacDonald","year":"1992","journal-title":"Gynaecological 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treatment of menorrhagia.","volume":"100","author":"Dwyer","year":"1993","journal-title":"Br J Obstet Gynaecol"},{"key":"2025122311593589000_309.6960.979.13","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1089\/gyn.1990.6.199","article-title":"Bowel injury from Nd:YAG endometrial ablation.","volume":"6","author":"Perry","year":"1990","journal-title":"J Gynecol Surg"},{"key":"2025122311593589000_309.6960.979.14","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91718-A"},{"key":"2025122311593589000_309.6960.979.15","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1111\/j.1471-0528.1992.tb14441.x","article-title":"Transcervical resection of the endometrium: a review of 400 consecutive patients.","volume":"99","author":"Rankin","year":"1992","journal-title":"Br J Obstet 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