[Radiomenolysis of the endometrium using high-dose iridium irradiation--clinical and cytologic results]

423 patients with benign recurrent uterine bleeding resistant to other therapy were treated by intracavitary radiotherapy. In all cases there was a contraindication for the operative removal of the uterus. Since 1980 radiomenolysis was performed by high-dose Iridium-192 irradiation (afterloading technique). In 94.3% of our cases with Radium-226 irradiation the bleeding could be treated successfully. Side effects of the irradiation occurred only in a minimal and neglectible percentage. In all cases irradiated with Iridium-192 the bleeding stopped after treatment. Side effects could not be observed. Therefore the intrauterine contact-irradiation therapy with high-dose Iridium-192 should be remembered in cases of uterine bleeding resistant to hormonal therapy or in cases of high risk for operation. With the afterloading device the molestation for the patients could be reduced to a minimum. By intrauterine exfoliative smear performed before and after irradiation the cytomorphologic effect of an Iridium-192 afterloading irradiation was demonstrated. The examinations showed that the cytologic findings were characteristic for the effect if ionizing radiation of the histologically unchanged, not radiosensitive, normal cylindrical epithelium. A marked cellular diathesis and augmentation of size of nuclei and plasma is a characteristic result of the irradiation with Iridium-192.