Improving results of hysteroscopic submucosal myomectomy for menorrhagia by concomitant endometrial ablation.

Abstract

STUDY OBJECTIVE:

To evaluate the effect of endometrial ablation on the outcome of premenopausal patients undergoing hysteroscopic myomectomy for menorrhagia or menometrorrhagia

DESIGN:

Retrospective cohort study (Canadian Task Force classification II-2).

SETTING:

Private practice.

PATIENTS:

One hundred seventy-seven women with one or more submucosal myomas experiencing menorrhagia or menometrorrhagia.

INTERVENTION:

Hysteroscopic myomectomy without endometrial ablation in 104 patients and with concomitant endometrial ablation in 73 patients.

MEASUREMENTS AND MAIN RESULTS:

Bleeding was controlled in 95.9% of patients with endometrial ablation and in 80.8% of patients without endometrial ablation (p = .003). Complete removal of the myoma led to better results (p = .039), which were further improved by endometrial ablation (p = .022). Endometrial ablation improved bleeding in patients whose myomas could not be completely removed, but the difference was not statistically significant (p = .23). Subsequent hysterectomies were not decreased by endometrial ablation (p = .48) or by complete removal of the myoma (p = .83). Hysterectomies for bleeding problems were decreased by endometrial ablation. Pain and dysmenorrhea were a frequent cause of hysterectomy.

CONCLUSION:

Endometrial ablation at the time of hysteroscopic myomectomy improves results in the control of bleeding.

• Authors: Franklin D Loffer
• Journal: Journal of minimally invasive gynecology (J Minim Invasive Gynecol) 2005 May-Jun Vol. 12 Issue 3 Pg. 254-60 ISSN: 1553-4650 [Print] United States
• PMID: 15922984 (Publication Type: Journal Article)

Topics

• Adult
• Electrocoagulation (methods)
• Endometrium (surgery)
• Female
• Humans
• Hysterectomy
• Hysteroscopy
• Leiomyoma (surgery)
• Menorrhagia (surgery)
• Middle Aged
• Uterine Neoplasms (surgery)