Clinical outcomes of OPERA, out-patient endometrial resection/ablation.
Objective: To evaluate the clinical outcomes of 18-month follow-up for OPERA, Out-Patient Endometrial Resection/Ablation using the (OPERA)Star tissue aspirating resectoscope.Methods: Patients suffering from abnormal uterine bleeding (AUB) and/or submucosal fibroids who where indicated for surgical intervention underwent OPERA for treatment of their condition using the (OPERA)Star tissue aspirating resectoscope. This resectoscope contains a tissue aspiration and morcellation channel for continuous removal of tissue strips. Follow-up assessments were conducted at 1 month, 3 months, 6 months, 12 months, and 18 months to evaluate long-term clinical results of the procedure. Data collected include current level of bleeding, subsequent procedures to manage condition, and patient's level of satisfaction.Results: A total of 33 patients presented with AUB requiring surgical intervention for relief of their symptoms. Uterine cavity averaged 10.7 cm (+/- 2.2), range 6.7-13.4 cm). Complete resection and ablation of the endometrium and submucosal fibroid(s) if present, was performed. Current 18-month follow-up data indicate that 21 (68%) patients achieved amenorrhea and 8 (26%) patients achieved hypomenorrhea. Two patients were lost to follow-up. Two patients underwent a subsequent procedure; one repeated OPERA and one hysterectomy for fibroids. Patient's overall satisfaction rate with the results of their procedure was 97%.Conclusion: OPERA is an effective minimally invasive method for management of abnormal uterine bleeding. At 18 months, clinical outcomes of OPERA indicate an optimal level of patient satisfaction for management of their bleeding with 94% of patients achieving either amenorrhea or hypomenorrhea. Continuous aspiration and morcellation during resection keeps the operative field clear of debris and simplifies the procedure.
Kresch
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Clinical Associate Professor, Stanford University School of Medicine, and Director, California Center of Pelvic Pain & Fertility, California, Palo Alto, USA