[Clinical observation of microwave endometrial ablation for treatment of abnormal uterine bleeding].
OBJECTIVE
To evaluate the efficacy, indication, and complication of microwave endometrial ablation (MEA) in treating abnormal uterine bleeding (AUB).


METHODS
One hundred and sixty-eight women with AUB due to benign causes received MEA treatment. Pre-operative endometrial thinning was carried out using uterine curettage. Then, the applicator radiating microwaves was moved by progressive withdrawal as well as "W" shape motion inside uterine cavity. All the patients were followed-up. The change of menstrual cycle, the amount of flow, dysmenorrhoea, anemia after treatment at 1, 3, 6, 12 and 24 months was recorded.


RESULTS
The mean operating time was (286 +/- 75) seconds. Average follow-up time was (22 +/- 6, range 6-36) months. Of these patients, 156 women (92.9%) were premenopausal, 97 cases (62.2%) were amenorrhea, 56 cases (35.9%) were hypomenorrhoea or eumenorroea, and 3 cases (1.9%) had irregular bleeding. The overall satisfaction of this treatment reached 98.1% (153/156). The follow-up of 119 cases was up to 24 months after operation. The concentration of hemoglobin in 107 women with anemia increased significantly from (83 +/- 24) g/L to (117 +/- 18) g/L 3 months after operation (P < 0.01). Dysmenorrhoea was relieved in 74.5% (35/47) patients. No bleeding occurred in any one of 12 postmenopausal patients after MEA. There was no intraoperative complication in any case. The procedure was successful in all of 47 patients with severe medical disorders. After operation, 12 cases were complicated with endometritis, 2 with hematometra, and one case was performed with hysterectomy due to postablation tubal sterilization syndrome.


CONCLUSIONS
MEA is a simple, safe and effective treatment of patients with abnormal uterine bleeding, especially suitable for those women associated with severe medical complications. Complete endometrial ablation is one of the most important determinants of treatment success. Stringent selection of patients may reduce the rate of complications.
Wang
Hui-lan
HL
Department of Obstetrics and Gynecology, Affiliated Second Hospital, Hebei Medical University, Shijiazhuang 050000, China.
Zhang
Xia
X
Chen
Su-qin
SQ
Yang
Yu-feng
YF
Sun
Xiu-zhi
XZ
Wang
Zhen-hai
ZH
D055356:Endometrial Ablation Techniques / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008597:Menstrual Cycle; D008872:Microwaves / Q000627:therapeutic use*; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000628:therapy*