Ablation of the Endometrium: Prospective 5-years“Follow up“ Study

Overview

Objective:
Objective of the study is to evaluate the effectivnes of endometrial ablation in patientswith persistent uterine bleeding who are unresponsive to conservative therapy.Design: Prospective clinical study.Setting: Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University andGeneral Faculty Hospital in Prague, Czech Republic.Methods: 100 women with intractable uterine bleeding were subjected to undergo endometrialablation. 44 patients were treated preoperatively not only with danazol or progestins but alsowith Norethisteron acetas to stop the acute bleeding preoperatively and 65 gave no preoperativedrug administration. Under appropriate anesthesia the cervix was dilated to 100 mm and theuterine cavity was distended with Purisol (Sorbitol and Manitol). Roller-ball coagulation techni-que combined with loop highfrequency endoresection was used in most of the patients (85 pati-ents). The findings of small uterine myoma(s) were not consider as a contraindication of theendometrial ablation.Results: At 51-2 months 42 (42 %) of patients reported amenorrhea, 51 (51 %) hypomenorrhea, 5(5 %) eumenorrhea and 2 (2 %) nochange. The mean time to complete operation was 30 minutes(range 15-45 minutes). The procedure was completed in all 100 women and we had no seriouscomplications.Conclusion: It is concluded, that endometrial ablation is safe and effective hysteroscopic proce-dure in the cases of abnormal uterine bleeding for women with normal uterine morfologicalfindings or small uterine myoma(s) considering the follow up 51-2 month of the study.

Key words:
uterus, bleeding, hysteroscopy, endometrium, resection