Surgical interventions: hysterectomy/endometrial destruction for excessive menstrual bleeding

It is little over a decade since hysteroscopic methods of endometrial destruction started to be rigorously assessed and were found to give the first effective alternative to hysterectomy as a surgical treatment for excessive or dysfunctional uterine bleeding (DUB) for 100 years (Table 1). The two initial methods were endometrial laser ablation (ELA) and transcervical resection of the endometrium (TCRE), later to be joined by rollerball endometrial ablation (REA).