Comparison of Partial and Complete Endomyometrial Resection with Rollerball Endometrial Ablation

Using chart review, telephone interviews, and questionnaires, we compared resectoscopic specimen findings in 63 consecutive women who underwent partial wire loop endomyometrial resection with rollerball endometrial ablation in early 1994, and 30 who underwent complete endomyometrial resection with rollerball endometrial ablation in late 1994 and early 1995. Follow-up ranged from 6 to 17 months. The average patient age was 46 years in both groups and complications were similar in both groups. In the former group, 42 women (66%) had amenorrhea, 19 (30%) had hypomenorrhea, and 2 were lost to follow-up. Histopathology in 44 patients (70%) showed 14 (22%) had polyps, 14 (22%) myomas, 11 (17%) adenomyosis, 8 (12%) endometrial hyperplasia, 1 endometritis, and 19 (30%) had no histopathology recorded. In the latter group, 26 women (86%) had amenorrhea and 4 (14%) had hypomenorrhea. Histopathology was recorded for all 30: 9 (30%) had polyps, 4 (13%) myomas, 14 (46%) adenomyosis, 4 (13%) endometrial hyperplasia, 2 (6%) endometritis, and 1 (3%) adenomyomas. Wire loop total endomyometrial resection with rollerball ablation was superior to partial endomyometrial resection and ablation in achieving amenorrhea (86% vs 66%, p <0.05) and hypomenorrhea (14%, p <0.10), and detecting underlying pathology such as adenomyosis (46% vs 12%, p <0.01).