Endo-miometrial vaporization in the treatment of abnormal uterine bleeding

Abstract

Today one of the most effective methods of the treatment of abnormal uterine bleeding in perimenopausal women is transcervical resection of endometrium (TCRE). However, using of this technology associates with high risk of developing itraoperative complications, such as: 1) intraoperative bleeding; 2) perforation of the uterus; 3) distention medium hazards. Therefore, we researched opportunity of the using of technology of vaporization of the uterus tissue to destruct endometrium and supeficial portion of miometrium. We performed transervical vaporization using continuous-flow system. All patients received uterine preparation prior to surgery within 2 months by Danazol or GnRG agonists.

Full Text

A new “OLYMPUS disk electrode” corrugated to provide high edgedensity electric power, has been used in the treatment of menorhagia to vaporize tissue. The use of 250-300 Watts power setting enables the “OLYMPUS disk electrode” to reduce bleeding, intravasation and dramatically reduces operating time. The endometrium in the cornual areas we destroyed by a roller ball electrode using 90-100 Watts power setting to avoid uterine pe foration. As distention media we used 5% solution of Glucosae.

This technology we pe formed on 66patients aged 48 ± 1,4 years (range 45-55). Neither uterine pe foration nor major complications occured. Control transvaginal and intrauterine sonography revieled complete coagulation of endometrium and induration of miometrium on depth of 8 mm. The patients were followed up 6 months after treatment. Amenorrhea was registered in all cases. Histological examination pe formed after 6 month’s postoperative period revieled fibrosis of miometrium on the depth of 5 mm (depth of cutting loop).