CLINICAL EFFICACY OF HYSTEROSCOPIC ENDOMETRI AL ABLATION AND FACTORS AFFECTING ITS SUCCESS

In order to assess the efficacy of hysteroscopic endometrial ablation and factors which are important in it's success, a prospective, randomized study was performed in Shiraz university hospitals between Sep. 1995 to Feb. 1998. 50 patients with chief complaints of menorrhagia that were in reproductive age (25- 50 years) and had shown no response to medication and D;C underwent endometrial ablation. Thirty-seven patients received pre-op medication and thirteen patients did not. All patients had undergone pre-operative endometrial sampling that had demonstrated benign histology. Eleven patients had submucosal myomas or pedunculated polyps that were resected at the time of hysteroscopic ablation. The minimum follow-up period was 1 year. Amenorrhea developed in 14% of patients, 50% of patients became hypomenorrheic and 30% eumenorrheic. Menorrhagia did not respond in 3 patients (6%). Hypermenorrhea was detected more commonly in younger patients. Type of endometrium, depth of the uterine cavity, presence of polyp or myoma and receiving pre-op medication were not important and did not affect patient response. Overall, the results of this study clearly indicate that endometrial ablation is a simple, effective and acceptable procedure for the management of intractable menorrhagia. The only factor which was important concerning the efficacy of endometrial ablation was patient age.