Endometrial ablation for dysfunctional uterine bleeding: role of GNRH agonists.
OBJECTIVE
To discuss a new alternative to treat patients with dysfunctional uterine bleeding who fail to respond to hormonal treatments, and to outline the role of GnRH analogs in the presurgical preparation of these patients.


METHODS
The causes and various hormonal treatments of dysfunctional uterine bleeding are outlined, and various methods of endometrial ablation, with hormonal and non-hormonal preparations, are reviewed,


RESULTS
In endometrial ablation, while hormonal preoperative treatments are more advantageous than no endometrial suppression, GnRH analogs prepare the endometrium better by reducing thickness uniformly, decreasing edema, and avoiding pseudo-decidual reaction usually present with other hormonal treatments.


CONCLUSIONS
Because success of endometrial ablation seems to correlate with uniform destruction of endometrium and superficial portion of myometrium, thinning of the endometrium hormonally simplifies the procedure, adds in the overall success of endometrial ablation, and reduces additional blood loss by controlling the bleeding preoperatively.
Valle
R F
RF
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D017115:Catheter Ablation / Q000379:methods; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053685:Laser Therapy / Q000379:methods; D016729:Leuprolide / Q000008:administration & dosage; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008595:Menorrhagia / Q000601:surgery*; D008598:Menstruation / Q000187:drug effects; D011292:Premedication; D014592:Uterine Hemorrhage / Q000601:surgery*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide