Frequency of symptomatic cornual hematometra and postablation tubal sterilization syndrome after total rollerball endometrial ablation: a 10-year follow-up.
OBJECTIVE
This study was undertaken to determine the frequency of symptomatic cornual hematometra and postablation tubal sterilization syndrome after total rollerball endometrial ablation and to describe methods for diagnosis, treatment, and prevention.


METHODS
Retrospective cases of 50 consecutive patients who received total rollerball endometrial ablation for dysfunctional uterine bleeding were followed up for 10 years.


RESULTS
Symptomatic cornual hematometra or postablation tubal sterilization syndrome was diagnosed by ultrasound scanning and/or magnetic resonance imaging in 5 of 50 patients (10%) who had a total endometrial ablation. Two patients had cornual hematometra, and 3 patients had postablation tubal sterilization syndrome 4 months to 90 months after rollerball ablation. Subsequent gonadotropin-releasing hormone agonist treatment or hysteroscopic decompression of the hematometra was only partially successful, and recurrence of symptoms necessitated hysterectomy with salpingectomy.


CONCLUSIONS
Uterine contracture, which obstructs bleeding from persistent cornual endometrium and leads to symptomatic cornual hematometra or postablation tubal sterilization syndrome, is not uncommon after total rollerball endometrial ablation, with an incidence of 10% in our series. Satisfactory treatment requires hysterectomy with salpingectomy, but modifications such as partial endometrial ablation can prevent these complications.
McCausland
Arthur M
AM
Department of Obstetrics and Gynecology, Sutter Medical Group and University of California at Davis Medical School, USA.
McCausland
Vance M
VM
D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods*; D019299:Decompression, Surgical; D004717:Endometrium / Q000601:surgery*; D005184:Fallopian Tube Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006409:Hematometra / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D007247:Infertility, Female / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014463:Ultrasonography
D007987:Gonadotropin-Releasing Hormone