Concomitant Laparoscopic Surgery and Hysteroscopic Endometrial Ablation for Women with Chronic Pelvic Pain and Menorrhagia
From September 1993 to July 1995, 63 women (mean age 38 yrs, range 26-53 yrs, parity 0-7) with chronic pelvic pain (CPP) and menorrhagia underwent outpatient laparoscopic surgery and endometrial ablation. Operating time ranged from 9 to 110 minutes (mean 52 min). Laparoscopic procedures included excision of endometriosis (26), adhesiolysis (17), electromyolysis (4), uterine suspension (6), and appendectomy (4). At 6 to 20 months' follow-up 63 women reported no pain (24, 38.1%), significant improvement of pain (25, 39.7%), no change in amount of pain (9, 14.3%), and an increase of pain (5, 7.9%). Six patients had repeat laparoscopy. After hysteroscopic endometrial rollerball ablation and resection, the same women reported amenorrhea (31, 49.2%), hypomenorrhea (26, 41.3%), eumenorrhea (3, 4.8%), and no change in menstrual bleeding (3, 4.8%). Two women had a repeat endometrial ablation and one had hysterectomy for menorrhagia and CPP. Concomitant laparoscopic surgery and endometrial ablation is an effective alternative to hysterectomy for women with CPP and menorrhagia.
Vilos
GA
Department of Obstetrics and Gynecology, St. Joseph's Health Centre, 268 Grosvenor St., London, Onatrio, Canada N6A 4V2.
Drossos
AD
Vilos
EC