[Endocavitary surgical procedures, an alternative to myomectomy in patients with symptomatic fibroids].

Abstract

Endometrial ablation can be used in heavy menstrual bleeding due to symptomatic submucosal myomas in women without desire of pregnancy. Those methods used alone, lead to an improvement on bleeding but results are not as good as in women without myomas. They can be associated with hysteroscopic myomectomy and, then, the results on bleeding are better than myomectomy alone. Second generation endometrial ablation methods must be used preferentially as they present less surgical complications than first generation methods. As the pregnancies that may occur after endometrial ablation have high risk of complications, a contraceptive mean is highly recommended after surgery. Transcervical sterilisation by intratubal insert (Essure) can also be proposed, but for women with Essure placed before endometrial ablation, only Thermachoice and bipolar resection have proven their safety. Finally, economical outcomes of endometrial ablation in myomas haven't been assessed yet.

• Authors: I De Jesus
• Journal: Journal de gynecologie, obstetrique et biologie de la reproduction (J Gynecol Obstet Biol Reprod (Paris)) Vol. 40 Issue 8 Pg. 937-43 (Dec 2011) ISSN: 1773-0430 [Electronic] France
• Vernacular Title: Alternatives endocavitaires à la myomectomie dans le traitement des fibromes symptomatiques.
• PMID: 22100862 (Publication Type: Evaluation Study, Journal Article, Review)
• Copyright: Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Topics

• Contraception (methods)
• Endometrial Ablation Techniques (methods, statistics & numerical data)
• Female
• Gynecologic Surgical Procedures (methods)
• Humans
• Hysteroscopy (methods)
• Leiomyoma (complications, surgery)
• Menorrhagia (etiology, surgery)
• Postoperative Complications (etiology, therapy)
• Pregnancy
• Pregnancy Complications, Neoplastic (prevention & control, therapy)
• Uterine Neoplasms (complications, surgery)