Resumption of menstruation after amenorrhea in women treated by endometrial ablation and myometrial resection

R Seeras, G.B. Gilliland
In: The Journal of the American Association of Gynecologic Laparoscopists · 1997 · vol. 4(3) , pp. 305–309 · doi:10.1016/s1074-3804(05)80220-8 · PMID:9154778 · W2082283181
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This paper investigated the resumption of menstruation in women who underwent endometrial ablation and myometrial resection procedures.

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Abstract

Study objectiveTo evaluate the prevalence of resumption of menstruation after an interval of amenorrhea in women treated by endometrial ablation and myometrial resection.DesignRetrospective analysis.SettingTertiary care university-affiliated teaching hospital.PatientsOne hundred fifty-seven consecutive patients treated for menorrhagia refractory to medical therapy.InterventionsLoop resection or rollerball ablation of the endometrium.Measurements and main resultsAt 6 to 12 months postoperatively, 50. 6% of patients were amenorrheic and 35.1% had hypomenorrhea. Over follow-up of 13 to 30 months, 45.1% of women became amenorheic and 40.5% had satisfactory hypomenorrhea. Resumption of menstruation after any interval of amenorrhea occurred in 27.2% of amenorheic patients. We observed an increasing trend to resumption of menstruation after rollerball ablation (29.4%) compared with loop resection (26.7%) and after preoperative endometrial suppression with buserelin (37.5%) and leuprolide (27.1%) compared with danazol (12.5%) and goserelin (10.5%). Resumption of menstruation occurred in 44.4% of women who did not have preoperative endometrial suppression.ConclusionsOur results suggest that resumption of menstruation does occur after a variable interval of amenorrhea following endometrial ablation and myometrial resection. It could potentially be used as a marker of failure of endometrial destruction.

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