Features of the post-operating period after the endometrial ablation in post-menopausal aged women with hyperplastic processes of endometrium

V.A. Benyuk, Victor Goncharenko, Oleksandr V Zabudskyi
In: HEALTH OF WOMAN · 2019 · pp. 60–67 · doi:10.15574/hw.2019.142.60 · W4285064623
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study compared hysteroscopic monopolar and radiowave endometrial ablation in postmenopausal women with hyperplasia, finding radiowave ablation 85% effective and monopolar ablation 96% effective with two years of recommended follow-up.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

The paper studied 45 postmenopausal women with non-atypical endometrial hyperplasia, comparing postoperative symptom/discharge patterns and follow-up findings after hysteroscopic endometrial ablation by monopolar (n=25) versus radiowave methods (n=20), with evaluations at early timepoints and up to 24 months using gynecologic exam, ultrasound, and office hysteroscopy or aspiration when indicated. It reported ablation effectiveness of 96.0% for monopolar and 85.0% for radiowave ablation, and stated that recurrence—identified by bleeding and/or increased M-echo thickness—warrants hysteroscopy with mandatory histopathological confirmation. A stated limitation/caveat is that recurrence assessment relied on symptom/imaging triggers and selective invasive evaluation rather than uniform sampling for all participants at all timepoints. This paper is centrally about endometriosis and/or adenomyosis—however, it does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

The paper presents the results of surgical treatment of 45 postmenopausal women with non-atypical forms of endometrial hyperplasia. The objective: is to establish the features of the postoperative period depending on the method of endometrial ablation in postmenopausal patients with endometrial hyperplastic processes. Materials and methods. The study included 45 women with non-atypical forms of endometrial hyperplasia: 25 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who were treated with hysteroscopic monopolar ablation of the endometrium and 20 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who underwent radiowave endometrial ablation. In the postoperative period, on 3, 7 days and after 1, 3, 6, 12, 24 months, the complaints, the general condition, the nature of the discharge from the genital tract were evaluated, gynecological examination with ultrasound examination of the pelvis were provided, office hysteroscopy or endometrial aspiration from the uterus were provided according to indications. Results. It is advisable to recommend endometrial ablation for the patients with non-atypical forms of postmenopausal endometrial hyperplasia as an alternative to hormonal treatment or hysterectomy. The efficiency of radiowave ablation of the endometrium with non-atypical forms of endometrial hyperplasia is 85.0%. The effectiveness of monopolar hysteroscopic ablation of the endometrium in women with non-atypical forms of endometrial hyperplasia is 96.0%. In the case of recurrence of the endometrial hyperplastic process (bleeding, thickening of the M-echo according to ultrasound data), hysteroscopy is shown with mandatory hystopathological studies and diagnosis verification. Conclusions. After ablation of the endometrium, follow-up is advisable for two years. The method of choice for follow-up observation of the state of the endometrium of the uterus in women after endometrial ablation is transvaginal ultrasound, which is performed after 1, 3, 6, 12 and 24 months of observation. Key words: endometrial hyperplastic processes, postmenopausal women, endometrial ablation.
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Materials

and methods. The study included 45 women with non-atypical forms of endometrial hyperplasia: 25 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who were treated with hysteroscopic monopolar ablation of the endometrium and 20 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who underwent radiowave endometrial ablation. In the postoperative period, on 3, 7 days and after 1, 3, 6, 12, 24 months, the complaints, the general condition, the nature of the discharge from the genital tract were evaluated, gynecological examination with ultrasound examination of the pelvis were provided, office hysteroscopy or endometrial aspiration from the uterus were provided according to indications. Results. It is advisable to recommend endometrial ablation for the patients with non-atypical forms of postmenopausal endometrial hyperplasia as an alternative to hormonal treatment or hysterectomy. The efficiency of radiowave ablation of the endometrium with non-atypical forms of endometrial hyperplasia is 85.0%. The effectiveness of monopolar hysteroscopic ablation of the endometrium in women with non-atypical forms of endometrial hyperplasia is 96.0%. In the case of recurrence of the endometrial hyperplastic process (bleeding, thickening of the M-echo according to ultrasound data), hysteroscopy is shown with mandatory hystopathological studies and diagnosis verification. Conclusions. After ablation of the endometrium, follow-up is advisable for two years. The method of choice for follow-up observation of the state of the endometrium of the uterus in women after endometrial ablation is transvaginal ultrasound, which is performed after 1, 3, 6, 12 and 24 months of observation. Key words: endometrial hyperplastic processes, postmenopausal women, endometrial ablation.

References

1. Benyuk VA, Goncharenko VN, Kuvita YuV. 2013. Intrauterine pathology: Doctor's Handbook «Gynecologist»: a guide. Kiev, Library «Health of Ukraine»: 203. 2. Benyuk VA, Goncharenko VN. 2014. Clinical and morphological rationale for the differential algorithm for treating endometrial hyperplastic processes in women of reproductive age «Protection of motherhood and childhood» Reviewed scientific and practical journal 1 (23): 17-21. 3. Goncharenko VM. 2017. Hyperplastic processes of endometrium. Forecasting, diagnostics, treatment and rehabilitation. Author's abstract doctr.med. sciences. Bogomolets National Medical University. Kyiv: 39 4. Dubossarskaya ZM, Dubossarskaya YuA, Goncharenko VN. 2005. Theory and practice of gynecological endocrinology. Dnepropetrovsk, PE «Lira LTD»: 412. 5. Zaporozhan VN, Tatarchuk TF, Dubinina VG. 2012. Modern diagnostics and treatment of endometrial hyperplastic processes. Reproductive endocrinology 1 (3): 32–38. 6. Tatarchuk TF, Burlaka EV. 2003. Modern principles of diagnosis and treatment of endometrial hyperplastic processes. Woman's health 4: 107–113. 7. Beniuk VO, Bubnov RV, Melnychuk O. 2016. Updating personalized management algorithm of endometrial hyperplasia in pre-menopause women. EPMA Journal 7(Suppl 1): A28. http://link.springer.com/article/10.1186/s13167-016-0054-6. (16.09.2015) 8. Beniuk V, Goncharenko V, Kalenska O, Demchenko O, Spivak M, Bubnov R. 2013. Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. EPMA Journal 4:24. Доступ: http://www.epmajournal.com/content/4/1/24/abstract (01.09.2013). https://doi.org/10.1186/1878-5085-4-24; PMid:24314145 PMCid:PMC3866390

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