Long-term histopathologic and morphologic changes after thermal endometrial ablation.
OBJECTIVE
To outline long-term histologic features of endometrial ablation.


METHODS
Prospective longitudinal study (Canadian Task Force classification II-3).


METHODS
Tertiary-care teaching hospital.


METHODS
Twenty-six patients.


METHODS
Thermal ablation followed by second-look office hysteroscopy with endometrial biopsy.


RESULTS
Mean follow-up time to second-look hysteroscopy after ablation was 33.4 +/- 2,1 months. Complete atrophy, partial adhesions or obliteration of the cavity, and fibrosis were observed at second-look hysteroscopy. Whereas all random biopsies were normal before ablation, biopsies after ablation revealed diminished endometrial glands with necrosis and scarring. The number of endometrial glands was not correlated with amount of bleeding or menstrual pattern. No premalignant or malignant lesions were found after ablation.


CONCLUSIONS
Although efficacy of endometrial ablation is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth is an expected development, not a failure of ablation.
Taskin
Omur
O
Department of Obstetrics and Gynecology, Akdeniz University Medical School, Antalya, Turkey.
Onoglu
Ahmet
A
Inal
Murat
M
Turan
Ersadik
E
Sadik
Salih
S
Vardar
Enver
E
Postaci
Hakan
H
Wheeler
James M
JM
D000328:Adult; D001284:Atrophy; D004564:Electrocoagulation; D004717:Endometrium / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D024162:Second-Look Surgery; D000267:Tissue Adhesions; D014591:Uterine Diseases / Q000209:etiology