title: A prospective study of rollerball endometrial ablation in the management of refractory recurrent symptomatic endometrial hyperplasia without atypia.
abstract: BACKGROUND
  Menorrhagia - heavy, extended or irregular menstruations - may be associated with endometrial hyperplasia. The aim of this study was to evaluate the clinical efficacy and safety of transcervical rollerball endometrial ablation (EA-R) and to discuss surgical outcomes in patients with simple endometrial hyperplasia without atypia who have had a history of medical treatment failure or recurrence.
  
  
  METHODS
  A prospective study was designed. Thirty women underwent EA-R. Preoperative and postoperative menstrual status, sexual activity, and satisfaction with the procedure were assessed. Complications, clinical outcomes, and need for re-intervention were evaluated.
  
  
  RESULTS
  No major complications occurred. All patients were discharged from hospital within 24 h. A reduction of menorrhagia was observed in patients as follows: 17 patients (56.67%) had amenorrhea, 10 (33.33%) hypomenorrhea, and 2 (6.67%) eumenorrhea. Hysterectomy was performed only in 1 patient who was unresponsive to ablation treatment.
  
  
  CONCLUSIONS
  In selected patients who have persistent uterine bleeding not responsive to conservative therapy, low risk for future endometrial cancer, and wish to retain their uterus, EA-R treatment is safe, effective, and might be an alternative to hysterectomy with good toleration and high rate of patient satisfaction. The advantages of EA-R include low incidence of complications, lower morbidity, shorter hospitalization, and faster recovery.
authors.affiliation: Departments of Obstetrics and Gynecology, Ümraniye Education and Research Hospital, Istanbul, Turkey.
authors.forename: Muhittin Eftal
authors.initials: ME
authors.lastname: Avci
authors.forename: Salih
authors.initials: S
authors.lastname: Sadik
authors.forename: Mustafa Gazi
authors.initials: MG
authors.lastname: Uçar
mesh_terms: D000328:Adult; D055356:Endometrial Ablation Techniques / Q000009:adverse effects; D004717:Endometrium / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007902:Length of Stay; D008595:Menorrhagia / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D018579:Patient Selection; D012008:Recurrence; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery*