title: Microwave endometrial ablation after endometrial curettage for the management of heavy menstrual bleeding.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the eticacy of microwave endometrial ablation after endometrial curettage, in selected patients with heavy menstrual bleeding.
  
  
  METHODS
  Thirty-two premenopausal women with heavy menstrual bleeding underwent microwave endometrial ablation at the Department of Obstetrics and Gynecology of the University of Patras Medical School. All patients did not respond to previous medical treatment, had completed their childbearing, and did not desire future fertility. The authors chose endometrial curettage rather than hormonal pretreatment (GnRH analogs, danazol) for endometrial preparation. Posttreatment follow up protocol included physical and ultrasonographic evaluation at three, six, nine, and 12 months for the first year and yearly after.
  
  
  RESULTS
  The authors had no cases of uterine perforation, thermal injury to adjacent organs, and infection or sepsis. During follow up, there was a gradual decrease in amenorrhea rate (90.6% - 68.8%) and in satisfaction rate (90.6% - 71.9%). Moreover during follow up, eight women underwent to total abdominal hysterectomy. Among them, seven women had uterine myomas and one woman had adenomyosis.
  
  
  CONCLUSIONS
  Endometrial preparation with endometrial curettage seems to be a good alternative to hormonal pretreatment. It has the advantage of avoiding delays, side effects, and cost of hormonal pretreatment. Moreover, microwave endometrial ablation after endometrial curettage is successful and highly acceptable.
authors.forename: M
authors.initials: M
authors.lastname: Nikolaou
authors.forename: G
authors.initials: G
authors.lastname: Androutsopoulos
authors.forename: G
authors.initials: G
authors.lastname: Michail
authors.forename: V
authors.initials: V
authors.lastname: Papadopoulos
authors.forename: G
authors.initials: G
authors.lastname: Adonakis
authors.forename: G
authors.initials: G
authors.lastname: Decavalas
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D055356:Endometrial Ablation Techniques / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece; D006801:Humans; D008595:Menorrhagia / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome