One-stage endometrial ablation: results in 200 cases

In: European Journal of Obstetrics & Gynecology and Reproductive Biology · 1992 · vol. 43(3) , pp. 209–214 · doi:10.1016/0028-2243(92)90175-x · PMID:1563572 · W2069400175
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This paper reports on the outcomes of one-stage endometrial ablation procedures performed in 200 patients.

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Abstract

Until now, endometrial ablation (EA) included at least three steps: (1) D & C or hysteroscopic endometrial sampling; (2) Danazol treatment; and (3) the ablation. We have found that step (2) can be omitted if EA is performed between days 2-7 of the menses. This permits to combine steps (1) and (3) into a single stage EA which is a very simple, feasible, efficient and safe treatment for dysfunctional bleeding. Simple: because one stage without hormonal pretreatment, causing almost no pain and only a minimal time off work. It is not more of a burden than D & C with hysteroscopy. General anaesthesia is used in 94% of our patients. Feasible: in one case only (GOPO) the cervix could not be dilated wide enough. Efficient: good results in 97.5%: 67% complete amenorrhea, 24% slight menstrual spotting for a maximum of 2 days, 6% reduced flow and 0.5% normal flow. There are 2.5% failures. When menorrhagia is accompanied by otherwise unexplained dysmenorrhea, the pain is completely cured in 73%, unchanged in 7% and greatly improved in 20%. Safe: mild complications in 2.5% only. We have also combined the two main methods of endometrial destruction: electrocoagulation and Nd/Yag laser. Our 97.5% good results, however, is not a definite proof that a combination of these two techniques is better than either technique alone.

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