Endometrial ablation. A report of four cases

Three women had evidence of atypical endometrial hyperplasia at the time of endometrial ablation, discovered because they had mechanical preparation of the endometrium rather than medical preparation. In one of these patients, a frozen section revealed atypical endometrial hyperplasia, and the ablation was cancelled. A fourth woman had an unsuccessful endometrial ablation; repeat ablation was followed by nine months of amenorrhea, at which time she began spotting and requested a hysterectomy. The pathology report on the hysterectomy specimen revealed adenomatous hyperplasia. Gynecologists must be vigilant in their evaluation of the endometrium before, during and after endometrial ablation.