Long-Term Histopathologic and Morphologic Changes after Thermal Endometrial Ablation

In: The Journal of the American Association of Gynecologic Laparoscopists · 2002 · vol. 9(2) , pp. 186–190 · doi:10.1016/s1074-3804(05)60130-2 · PMID:11960046 · W2072302428
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This study describes the long-term histopathologic and morphologic changes observed in the endometrium following thermal endometrial ablation.

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Abstract

Study objectiveTo outline long-term histologic features of endometrial ablation.DesignProspective longitudinal study (Canadian Task Force classification II-3).SettingTertiary-care teaching hospital.PatientsTwenty-six patients.InterventionThermal ablation followed by second-look office hysteroscopy with endometrial biopsy.Measurements and main resultsMean follow-up time to second-look hysteroscopy after ablation was 33.4 +/- 2,1 months. Complete atrophy, partial adhesions or obliteration of the cavity, and fibrosis were observed at second-look hysteroscopy. Whereas all random biopsies were normal before ablation, biopsies after ablation revealed diminished endometrial glands with necrosis and scarring. The number of endometrial glands was not correlated with amount of bleeding or menstrual pattern. No premalignant or malignant lesions were found after ablation.ConclusionAlthough efficacy of endometrial ablation is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth is an expected development, not a failure of ablation.

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