Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


The aim of the study is to compare the effectiveness of the use of hormonal drugs before hysteroresectoscopic ablation of the endometrium in premenopausal patients with abnormal uterine bleeding. Were examined 145 women aged from 45 to 54 years with recurrent endometrial hyperplasia, which were divided into three groups depending on the preoperative use of one of the hormonal drugs (gestagen preparation, microdose estrogen-gestagen contraceptive, gonadotropin-releasing hormone agonist - GnRHa). When medication-induced endometrial atrophy was achieved, the patients underwent hysteroresectoscopic endometrial ablation using the coagulation vaporization technique. The results of the study showed the feasibility of preoperative thinning of the uterine mucosa to improve the results of treatment of its benign changes. The most effective means for accelerating the attainment of drug regression of the endometrium were GnRHa, whose effectiveness was 95.7%. The estrogen-gestagen-containing contraceptive and gestagen preparation showed an efficacy of 65.3% and 42.8%, respectively. The results of the study should be considered when choosing the optimal tactics for management of premenopausal patients with abnormal uterine bleeding.

Full Text

Restricted Access

About the authors

Sergey P. Sinchikhin

Astrakhan State Medical University

414000, Astrakhan, Russian Federation
Dr. med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Medicine, “Astrakhan State Medical University”, 414000, Astrakhan

E. V Kostenko

Astrakhan State Medical University

414000, Astrakhan, Russian Federation

L. V Stepanyan

Astrakhan State Medical University

414000, Astrakhan, Russian Federation


  1. Woods S., Taylor B. Global ablation techniques. Review. Obstet. Gynecol. Clin. 2013; 40(4): 687-95.
  2. Bofill Rodriguez M., Lethaby A., Grigore M., Brown J., Hickey M., Farquhar C. Endometrial resection and ablation techniques for heavy menstrual bleeding. Cochrane Database Syst. Rev. 2019; 22(1): CD001501.
  3. Fergusson R.J., Lethaby A., Shepperd S., Farquhar C. Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database Syst. Rev. 2013; 29(11): CD000329.
  4. Spencer J.C., Louie M., Moulder J.K. Cost-effectiveness of treatments for heavy menstrual bleeding. Obstet. Gynecol. 2017; 25: 23-6.
  5. Попов А.А., Мананникова Т.Н., Алиева А.С., Барто Р.А. Аблация эндометрия при гиперпластических процессах у женщин перименопаузального возраста. Архив акушерства и гинекологии им. В.Ф. Снегирёва. 2016; 3(4): 211-2
  6. Vilos G.A., Oraif A., Ettler H., Edris F., Abu-Rafea B. Long-term clinical outcomes after resectoscopic endometrial ablation of nonatypical endometrial hyperplasia in women with abnormal uterine bleeding. J. Minim. Invasive Gynecol. 2015; 22(4): 704.
  7. Simon R.A., Quddus H.R., Lawrence W.D., Sung C. Pathology of endometrial ablation failures: a clinicopathologic study of 164 cases. Int J. Gynecol. Pathol. 2015; 34(3): 245-52.
  8. Moulder J.K., Yunker A. Endometrial ablation: consideration and complications. Obstet. Gynecol. 2016; 28(4): 261-6.
  9. Саркисов С.Э., Уланкина О.Г. Отдалённые результаты лечения гиперпластических процессов эндометрия после аблации эндометрия. Онкогинекология. 2016; 1: 18-23
  10. McGurgan P.M., McIlwaine P. Complications of hysteroscopy and how to avoid them. Best Pract. Res. Clin. Obstet. Gynaecol. 2015; 29(7): 982-93.
  11. Tan Y.H., Lethaby A. Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding. Review. Cochrane Database Syst. Rev. 2013. doi: 10.1002/14651858.CD010241.pub2
  12. Рымашевский А.Н., Воробьёв С.В., Андрющенко Ю.А. Клиническая эффективность комбинированной оперативной и гормонально-метаболической терапии полипов эндометрия у женщин с ожирением в постменопаузе. Современные проблемы науки и образования. 2011; 3: 16.
  13. Багдасарян А.Р., Саркисов С.Э. Осложнения диагностической и оперативной гистероскопии. Акушерство и гинекология. 2014; 1: 36-40
  14. Morelli M., Rocca M.L., Mocciaro R., Di Cello A., Sacchinelli A., De Trana E. еt al. Sonographic findings in postmenopausal women with a prior endometrial ablation: interpretation and management of women with endometrial thickening and bleeding. J. Minim. Invasive Gynecol. 2015; 22(3): 489-94
  15. Уланкина О.Г., Саркисов С.Э. Применение комбинированного метода лечения при сочетании гиперпластического процесса эндометрия с аденомиозом. Акушерство и гинекология. 2018; 4: 119-24
  16. Oraif A.A., Smith J., Vilos A.G., Abduljabar H., Hollett-Caines J. Single injection of Depomedroxyprogesterone acetate (Dmpa) immediately after rollerball endometrial ablation significantly improves clinical outcomes in women with heavy menstrual bleeding. J. Minim. Invasive Gynecol. 2015; 22(6): 5
  17. Синчихин С.П., Мамиев О.Б., Степанян Л.В., Эльдерова К.С., Магакян О.Г. Некоторые современные аспекты воспалительных заболеваний органов малого таза. Consilium Medicum. 2015; 17(6): 73-6.
  18. Бабурин Д.В., Унанян А.Л., Сидорова И.С., Кудрина Е.А., Ищенко А.И. Гиперпластические процессы эндометрия у женщин перименопаузального возраста: клинические аспекты проблемы. Архив акушерства и гинекологии им. В.Ф. Снегирёва. 2017; 4(4): 201-7.



Abstract - 36

PDF (Russian) - 0


Article Metrics

Metrics Loading ...


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies