Name a surgical option for refractory AUB.

Name a surgical option for refractory AUB.

• A. Oophorectomy
• B. Pelvic floor repair
• C. Hysterectomy
• D. Endometrial ablation

Answer: (C)

When abnormal uterine bleeding persists despite medical therapy, the goal becomes definitive control of the bleeding. Hysterectomy achieves that by removing the uterus, so there is no endometrial source to bleed from. This offers durable, often complete resolution of AUB for patients who have completed childbearing or who prefer a permanent solution and are suitable candidates for surgery. Modern approaches—vaginal, abdominal, laparoscopic, or robotic—provide options with varying recovery times and risks, but the end result is reliable cessation of menorrhagia. Endometrial ablation can reduce bleeding and is a uterus-preserving option, but it’s not as definitive; it may fail over time or be unsuitable in the presence of fibroids, adenomyosis, or atypical hyperplasia, and some patients eventually need a hysterectomy anyway. Oophorectomy is not a primary treatment for AUB and introduces surgically induced menopause, with broader systemic effects. Pelvic floor repair addresses prolapse or incontinence, not the bleeding source.

When abnormal uterine bleeding persists despite medical therapy, the goal becomes definitive control of the bleeding. Hysterectomy achieves that by removing the uterus, so there is no endometrial source to bleed from. This offers durable, often complete resolution of AUB for patients who have completed childbearing or who prefer a permanent solution and are suitable candidates for surgery. Modern approaches—vaginal, abdominal, laparoscopic, or robotic—provide options with varying recovery times and risks, but the end result is reliable cessation of menorrhagia.

Endometrial ablation can reduce bleeding and is a uterus-preserving option, but it’s not as definitive; it may fail over time or be unsuitable in the presence of fibroids, adenomyosis, or atypical hyperplasia, and some patients eventually need a hysterectomy anyway. Oophorectomy is not a primary treatment for AUB and introduces surgically induced menopause, with broader systemic effects. Pelvic floor repair addresses prolapse or incontinence, not the bleeding source.