Endometrial ablation for intractable uterine bleeding: hysteroscopic resection

Twenty-one patients with intractable uterine bleeding were treated by resectoscopic ablation of the endometrium. All the patients were worked up thoroughly to rule out hormonal or anatomic reasons for their bleeding. In addition, various hormonal regimens were tried to stop the bleeding. Our technique used the modified urologic resectoscope, which is inserted into the uterine cavity. The entire endometrial cavity was ablated using 30 W of coagulating current. Of the 21 patients treated, 14 had blood dyscrasias, four were poor anesthetic risks, and three refused hysterectomy. There were no complications from the procedure. Three patients died from their primary disease, and all the rest, except for one, remained amenorrheic. We conclude that the use of the resectoscope for endometrial ablation is a successful, efficient, safe, and readily available way to treat intractable uterine bleeding.