Endometrial ablation: indications and preliminary diagnostic hysteroscopy

Endometrial ablation is indicated when a woman with excessive uterine bleeding has, completed childbearing, been shown to suffer from dysfunctional bleeding, has exhausted all reasonable nonsurgical alternatives and would previously have been offered a hysterectomy. Diagnostic hysteroscopy is an integral part of the investigation of such a patient. Its primary function is to identify intrauterine lesions which might, if treated alleviate the need for ablation, or if untreatable, constitute contraindications to ablation. This chapter describes in detail the indications for and contraindications to, ablation. A short description of the medical management of dysfunctional bleeding is given. The instruments, technique and hysteroscopic findings which may be encountered are discussed.