Perioperative factors for predicting successful hysteroscopic endometrial ablation.
OBJECTIVE
To investigate factors affecting the success of hysteroscopic endometrial ablation in order to improve patient counseling.


METHODS
Preoperative patient characteristics (age, parity, uterine length, and presence and location of myomas) and intraoperative factors (intracavitary findings, ablation or resection, and operator) were analyzed. Forty-three women with a uterine size of < or = 10 weeks underwent hysteroscopic endometrial ablation or resection and had a median follow-up of 20 months. All were treated with depot triptorelin, 3.75 mg, 1 month prior to the procedure. Alleviation of menorrhagia and amenorrhea was classified as treatment success. Comparative analyses were made between patients with failed vs. successful procedures and with reduced bleeding vs. those with amenorrhea following surgery.


RESULTS
Thirty-seven women (86%) reported a decrease in menstrual flow or amenorrhea. In 6 patients (14%), bleeding persisted or became more severe. There were no statistically significant differences between women who had successful vs. failed procedures with regard to all preoperative and intraoperative parameters analyzed. Patients with amenorrhea were significantly older as compared to women with reduced bleeding (47.5 +/- SD 5.0) vs. 44.0 +/- SD 4.1 years, P = .03.


CONCLUSIONS
Most women with uterine size of < or = 10 weeks may expect alleviation of menorrhagia or amenorrhea after surgery. Apart from age, all other preoparative and intraoperative factors examined had no predictive value for a successful procedure. These data are valuable for proper patient counseling before hysteroscopic endometrial ablation.
Gemer
Ofer
O
Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, 78306 Israel. gemer@barzi.health.gov.il
Kapustian
Viki
V
Kroll
Dov
D
Tur-Kaspa
Ilan
I
Segal
Shmuel
S
D000328:Adult; D000367:Age Factors; D000568:Amenorrhea; D003376:Counseling; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007889:Leiomyoma / Q000601:surgery; D008595:Menorrhagia / Q000473:pathology / Q000601:surgery*; D008598:Menstruation; D008875:Middle Aged; D010298:Parity; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000473:pathology