[Non-hysteroscopic thermodestruction of the endometrium using radio waves in the treatment of menorrhagia].
OBJECTIVE
To test non-hysteroscopic thermodestruction of the endometrium for safety and efficiency.


METHODS
Prospective pilot study from February 1991 to July 1992.


METHODS
University Hospital Nijmegen.


METHODS
There were 68 patients aged 30-55 years with menorrhagia, who did not want children but wished to retain the uterus. There were two patients with a subserous myoma but with a normal uterine cavity. Patients with hypergonadotropism, a markedly enlarged uterus, abnormalities at cytological examination of the cervix, adnexal lesions, prolapse, intrauterine lesions and coagulation disorders were excluded. By way of preparation, danazol was administered for 4 weeks before the intervention (36 patients). Three patients with side effects were given lynestrenol. From January 1992, an LH-RH analogue was administered (29 patients) for 6 weeks prior to the intervention or in the patients with a subserous myoma for 12 weeks. Thermodestruction of the endometrium by means of radio waves was carried out according to a standard protocol under general or epidural spinal anaesthesia. The intracavitary temperature measured was 62-65 degrees C, mean duration of the treatment 20 minutes.


RESULTS
The patients were discharged 10-24 hours after the intervention. A non-disturbing watery discharge of 3-6 weeks' duration was reported. Normal activities were resumed after one week. Success (duration of follow-up 3-21 months) was defined as amenorrhoea (6 patients; 9%) or a markedly reduced menstruation or duration of menstruation (48 patients; 70%). Six patients (9%) reported no improvement and of eight patients (12%) with slight, unsatisfactory improvement three were treated again, with success (4%). During the trial period the method was further adjusted and perfected. There were no complications.


CONCLUSIONS
This preliminary experience shows that thermodestruction with radio waves is simple, safe and efficient.
Academisch Ziekenhuis, afd. Gynaecologie en Verloskunde, Nijmegen.
R F
RF
Thijssen
J M
JM
Dony
R
R
Rolland
D000328:Adult; D003972:Diathermy / Q000295:instrumentation / Q000379:methods*; D004717:Endometrium / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008028:Light Coagulation; D008595:Menorrhagia / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies