Hysteroscopic endometrial ablation without endometrial preparation

• Published in: International journal of gynecology and obstetrics 1998-08, Vol.62 (2), p.167-172
• Main Authors: Yin, C.S, Wei, R.Y.-C, Chao, T.-C, Chan, C.-C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Chronic Disease; Endometrial ablation; Endometrium - surgery; Endoscopy; Feasibility Studies; Female; Humans; Hystero-resectoscope; Hysteroscopy; Medical sciences; Menorrhagia; Menorrhagia - surgery; Middle Aged; Patient Satisfaction; Reoperation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Treatment Outcome
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/S0020-7292(98)00061-7

Objective: To study the effectiveness of endometrial ablation by hysteroscopic resection without prior medical preparation for the treatment of women with persistent menorrhagia. Method: From January 1996 to January 1997, a total of 170 women with persistent menorrhagia and/or dysmenorrhea and who underwent hysteroscopic endometrial resection were included in the study. A thorough suction curettage was done before the procedure. The operation was conducted through a continuous flow hysteroscopic resectoscope with electrosurgery while the patient was under intravenous general anesthesia. The distention fluid used was 5% dextrose with a gravity feed infusion system consisting of a 2-l bag between 1 and 1.5 m above the uterine cavity. After the procedure, the patients' conditions were followed for at least 6–18 months by telephone interview or at our clinic. Results: A total of 127 women were available for a follow-up period of at least 6 months. Operative complications were 3%; three women had fever and received oral antibiotics; no uterine perforation occurred; one case of post-operative bleeding was controlled by intrauterine balloon inflation; the average operation time was 21 min; The mean fluid deficit was 435 ml. Ninety-nine out of 127 women (78%) had adequately controlled menorrhagia (18.1% had amenorrhea, 42.5% hypomenorrhea and 17.3% had normal menstrual flow), while 27 women (21.2%) were failed due to unchanged or heavier menstrual flow after surgery. Eleven (40%) out of the 27 failed cases had myoma with menorrhagia, whereas only five women (5%) out of the 99 adequately treated women had myomas ( P