Mrs Y 45 yr old housewife came with menstrual complaints of recent origin.She gave a history of prolonged menstrual cycle with dysmenorrhoea and clots.She had similar menstrual complaints in the past which had subsided with hormonal treatment.Her Pelvic Sonography was suggestive of cystic endometrial hyperplasia(thickened endometrium) with loss of junctional endometrium myometrium zone suggestive of signs of Adenomyosis.Uterus was enlarged with PCOM polycystic ovarian morphology .She had gained weight over past few years and was on medications for thyroid dysfunction.
After pelvic examination she was counselled and treatment options discussed.
A)Medical management with a combination of tranexamic acid preparation and progestins
explained for a minimum of 6 months .
B)TCRE transcervical resection of endometrium + Intrauterine progesterone device.
C)Failure to respond to above given options than plan Minimally Invasive Hysterectomy.
Mrs.Y decided to undergo TCRE+IUD transcervical resection of endometrium with progesterone
intrauterine device.
Post procedure she benefited,her menstrual cycles duration was reduced.They had become non
painful and she was no longer passing clots.