Photodynamic endometrial ablation: morphological study.
OBJECTIVE
Endometriumablation provides an alternative treatment modality to hysterectomy for dysfunctional uterine bleeding (DUB). Its feasibility was demonstrated in animal studies. The purpose of this study was the evaluation of histological changes following photodynamic endometrial ablation in patients.


METHODS
5-Aminolevulinic acid (ALA) was topically applied in three premenopausal and one postmenopausal patient 4-6 hours before laser-illumination. ALA-concentration: 100-400 g/ml, NaOH-titration (pH 5.5). Volume applied, 1.5-2.0 ml; intrauterine balloon-lightdiffuser; wavelength, 635 nm; lightdose, 160 J/cm(2). Hysterectomy was performed 3-152 days after photodynamic ablation. Histological examination was carried out on endometrium sections stained with hematoxylin and eosin (H&E).


RESULTS
Necrosis including the full thickness of the endometrium was found 3 days after photodynamic endometrial ablation. Specimens collected after 35 and 152 days did not exhibit fibrosis or adhesions. Foci of preserved endometrium were detected in all patients.


CONCLUSIONS
Photodynamic endometrial ablation is selective and does not cause endometrial fibrosis or adhesions.
Wyss
Pius
P
Department of Obstetrics and Gynecology, University Hospital of Zurich, Zürich 8091, Switzerland. pius.wyss@fhk.usz.ch
Caduff
Rosmarie
R
Tadir
Yona
Y
Degen
Andrea
A
Wagnières
Georges
G
Schwarz
Viola
V
Haller
Urs
U
Fehr
Mathias
M
D000328:Adult; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D004717:Endometrium / Q000187:drug effects*; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000188:drug therapy*; D008875:Middle Aged; D010778:Photochemotherapy
D000622:Aminolevulinic Acid