Therapeutic outcomes and postoperative courses in microwave endometrial ablation for menorrhagia

Objective: Microwave endometrial ablation (MEA) with a 2.45 GHz microwave was first in Japan performed to treat intractable menorrhagia by Kanaoka et al. in 1998. Since then satisfactory results have been reported. The present study was conducted to assess symptomatic rating improvements, complication statuses and evidence of no recurrence after surgery.Methods: MEA was performed on 30-51-year-old patients with complaint of menorrhagia (52 patients) or prolonged menstruation (3 patients). Postoperative findings were evaluated, including subjective symptoms, hematological improvement ratings and complication statuses, with periodic ambulatory follow-ups for recurrences and complications. Also studied were patients with complicating dysmenorrhea.Results: All 52 patients with menorrhagia achieved amelioration of their subjective symptoms; in 92.2% of treated cases, anemia treatment became no longer necessary. All 3 patients with prolonged menstruation achieved remarkable amelioration. In all patients who experienced recurrent menorrhagia requiring treatment after surgery, the recurrence was within 6 months and no patients were experienced recurrent disease beyond 6 months after surgery. One patient experienced pyosalpinx one month after surgery; she underwent hysterectomy and salpingooophorectomy. In three other patients, endometrial cytology was not available, due to cavity adhesion; however, no other severe complications were observed. Effective amelioration of dysmenorrhea was obteined in 94.7% (18/19) of the patients without complicating adenomyosis uteri, but the ratio was low, at 66.7% (12/18), in the patients with complicating adenomyosis uteri.Conclusion: MEA is potentially a safe and highly effective surgical procedures for menorrhagia, when performed taking into account its technical features, indications and complications. It seems necessary to follow the course for at least six months after surgery.