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Menorrhagia Research Paper

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Introduction
Menorrhagia, or heavy menstrual flow, is one of the greatest common complaints met by primary care doctors and gynecologists. It is defined as menstrual loss of more than 80 mL. This translates to menses that continues for more than seven days or the use of more than 10 pads or tampons per day. It is most commonly associated with perimenopause. (1) Although menorrhagia is not fatal, it can cause chronic anemia, pelvic pain and cramping. The condition also severely influences quality of life by disrupting work, social functioning and family life.(2) The old-style primary management for menorrhagia caused by submucosal myomas or endometrial polyps involved major surgical procedure, with menorrhagia responsible for almost 20 percent …show more content…

Between 5 and 10 percent of all U.S. women complain to their doctors about menorrhagia (3), which affects more than 10 million annually. (2)
Menorrhagia can have hormonal or non-hormonal causes. Uterine fibroids, or myomas, are a common non-hormonal cause. (1) Clinically, there are three main categories of myomas, classified according to their site in the uterus: subserosal myomas grow in the outer portion of the uterus, intramural myomas develop within the uterine wall, and submucosal myomas grow just below the lining of the uterine cavity and close to the endometrial cavity. This last group of myomas, the submucosal, that have the most effect on menorrhagia.(4,5) Because of their location on the endometrium, these myomas place pressure on the uterine lining that builds with each menstrual cycle. This, in turn, can cause heavy bleeding. Even very small submucosal myomas may cause very heavy bleeding.(4,5) Myomas in the submucosal location specifically may cause abnormal uterine bleeding or subfertility, and are agreeable to hysteroscopic removal. The European Society of Gynecological Endoscopy (ESGE) classifies submucosal myomas as Type 0 if the entire lesion is intracavitary, Type I if less than 50% extends into the myometrium, and Type …show more content…

It is quicker, simpler, safer lesion removal. In 2005, the US Food and Drug Administration (FDA) approved the TRUCLEAR™ hysteroscopic morcellator (Smith & Nephew, Andover, MA) as the first motorized morcellator for intrauterine pathology. In 2009, the FDA approved another hysteroscopic morcellation device—the MyoSure® Tissue Removal System (Hologic, Bedford, MA). Similar to the first generation TRUCLEAR, the second generation MyoSure system depends on a suction-based, mechanical energy, rotating tubular cutter system rather than the high-frequency electrical energy historically used by resectoscopy systems to eliminate intrauterine tissue.(20) Once placed inside the uterine cavity, the device shaves off and immediately suctions out any excised tissue that might impair visibility. The ability to remove and instantly suction out tissue fragments means the hysteroscopy and morcellator are inserted only once, for initial entry. This is a huge advantage from both the physician's and the patient's point of view. For the physician, the immediate removal of tissue through the probe makes surgery much simpler to perform and requires less surgical time. The advantage for the patient is a much safer treatment. Shorter operating time means less exposure to general anesthesia and puts the

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