Comparison of the long-term histopathologic and morphologic changes after endometrial rollerball ablation and resection: a prospective randomized trial.
OBJECTIVE
To compare long-term histologic features of endometrial rollerball ablation versus resection.


METHODS
Randomized clinical trial (Canadian Task Force classification I).


METHODS
Akdeniz University School of Medicine.


METHODS
Women with menorrhagia undergoing endometrial ablation.


METHODS
Comparison of patients with menorrhagia undergoing endometrial resection and ablation.


RESULTS
Endometrial rollerball ablation (n = 23 women) and resection (n = 25) were followed by second-look office hysteroscopy with endometrial biopsy. Mean follow-up to second look hysteroscopy after rollerball ablation and loop resection was 33.4 +/- 2.1 and 31.1 +/- 2.6 months, respectively. Complete atrophy and partial adhesion or obliteration of the cavity and fibrosis were observed at second-look hysteroscopy and were similar in both groups. Whereas all random biopsy specimens after both ablation and resection revealed diminished endometrial glands with varied necrosis and scarring, the number of endometrial glands per field was not correlated with amount of bleeding or menstrual pattern. Bleeding patterns were similar between the groups. No precancerous or malignant lesion was found after the procedures.


CONCLUSIONS
Although efficacy of both endometrial ablation and resection is related to initial thermal destruction and correlated with postablation hysteroscopic and histologic findings, endometrial regrowth may be expected and is not a failure of ablation. Both procedures revealed histopathologically and clinically similar results.
Onoglu
Ahmet
A
SSK Tepecik Hospital, Antalya and Izmir, Turkey.
Taskin
Omur
O
Inal
Murat
M
Sadik
Salih
S
Simsek
Mehmet
M
Akar
Munire
M
Kursun
Sinan
S
Mendilcioglu
Inanc
I
Postaci
Hakan
H
Ispahi
Cigdem
C
D000328:Adult; D004564:Electrocoagulation; D004717:Endometrium / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D024162:Second-Look Surgery; D016896:Treatment Outcome