Endometrial ablation with the combined Nd:YAG laser-rollerball.
Endometrial ablation, an effective treatment for intractable uterine bleeding, can be performed with hysteroscopic rollerball coagulation, neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, and endomyometrial resection techniques. Between November 1990 and January 1995, 49 women underwent ablation with the Nd:YAG laser and a nontouch technique on the ostia, uterine fundus, and upper one-third to one-half of the posterior uterine wall, in combination with rollerball coagulation over the entire endometrial surface after 60-W Nd:YAG application. The power source of the rollerball was set at 80 W of pure coagulation current. Each patient was pretreated with a gonadotropin-releasing hormone agonist or an antiestrogenic compound. The complications were one uterine perforation with a dilator with no sequelae, and one severe infection requiring hysterectomy. There were no failures. Of the 48 women available to follow-up, amenorrhea was achieved in 43 (90%). Two continued to spot very slightly on occasion, but did not require minipads. Three women had light flow requiring one to two tampons for 1 to 4 days every month. The technique continues to provide a very high rate of complete amenorrhea.
Taylor
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9690 South 1300 East, Suite 302, Salt Lake City, UT 84094, USA.
D000328:Adult; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects; D008595:Menorrhagia / Q000601:surgery; D008875:Middle Aged; D009215:Myometrium / Q000601:surgery; D011292:Premedication; D014592:Uterine Hemorrhage / Q000601:surgery*