[Neodymium-Yag laser in the treatment of benign endometrial pathology after preparation by slow-release triptorelin]

Twenty-one patients with uterine bleeding who failed to respond to pharmacological treatment underwent Nd-Yag endometrial photocoagulation following preparation with slow-release triptorelin. All patients were carefully selected after a complete clinical, echographic, hormonal, hysteroscopic and histological screening. Subjects with menometrorrhagia due to high-risk endometrial pathologies and various causes were excluded from the study. The technique uses a modified urological resectoscope which enables the Nd-Yag laser optic fibre to be inserted and to move the tip by 30 degrees. The entire endometrial cavity was treated using a power of between 40 and 60 watts and in all cases analogs were administered preparatively for 3 months prior to surgery (slow-release triptorelin). No complications arose during treatment. Operating times were between 40 and 90 minutes. Fourteen of the patients currently do not report cyclical bleeding; 7 have modified periodic bleeding (3 with algomenorrhea which is overcome using bland oral analgesics). In conclusion the authors affirm that the technique is of considerable value, but requires lengthy training for operators and undoubtedly a high initial cost of equipment which is only justified by multidisciplinary use.