[Endometrial ablation: prospective 3-year follow-up study]

Area of Science:

• Gynecology
• Minimally Invasive Surgery

Background:

• Persistent uterine bleeding unresponsive to conservative therapy presents a treatment challenge.
• Endometrial ablation offers an alternative to hysterectomy for select patients.

Purpose of the Study:

• To evaluate the safety and efficacy of hysteroscopic endometrial ablation for intractable uterine bleeding.

Main Methods:

• 50 women with intractable uterine bleeding underwent endometrial ablation using roller-ball coagulation and loop resection techniques.
• Preoperative medical treatments varied, including danazole, progestins, or no treatment.
• Small uterine myomas were not considered contraindications.

Main Results:

• 96% patient satisfaction reported.
• Amenorrhea achieved in 44%, hypomenorrhea in 48% within 3-5 months.
• The procedure had a mean operative time of 25 minutes with no serious complications.

Conclusions:

• Endometrial ablation is a safe and effective hysteroscopic procedure for abnormal uterine bleeding in women with normal uterine morphology or small myomas.
• A 10% rate of secondary hysterectomy was noted, primarily due to myoma with adenomyosis, highlighting the need for careful patient selection.