Hysteroscopic endometrial ablation with the neodymium-YAG laser

Over the past 3 years a series of patients referred to the gynaecological department at Stobhill Hospital with menorrhagia have been treated, as an alternative to hysterectomy, by endometrial ablation with the neodymium-YAG laser. The results in the first 25 patients with a follow-up of over 6 months are presented. The overall success rate was only 52%, but by increasing the power output of the laser energy used to 80 W the rate of success increased to 83%. Of the 25 patients 13 were selected for laser treatment because hysterectomy was considered unsuitable on account of obesity or medical and surgical conditions; the other 12 wanted to avoid a hysterectomy. The technique and its problems are discussed.