Improving results of hysteroscopic submucosal myomectomy for menorrhagia by concomitant endometrial ablation

STUDY OBJECTIVE: To evaluate the effect of endometrial ablation on the Outcome of premenopausal patients undergoing hysteroseopic myomectomy for menorrhagia or menometrorrhagia DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Private practice. PATIENTS: One hundred seventy-seven women with one or more submucosal myomas experiencing menorrhagia or menometrorrhagia. INTERVENTION: Hysteroscopic myomectomy without endometrial ablation in 104 patients and with concomitant endometrial ablation in 73 patients. MEASUREMENTS AND MAIN RESULTS: Bleeding was controlled in 95.9% of patients with endometrial ablation and in 80.8% of patients without endometrial ablation (p =.003). Complete removal of the myoma led to better results (p =.039). which were further improved by endometrial ablation (p =.022). Endometrial ablation improved bleeding in patients whose myomas could not be completely removed, but the difference was not statistically significant (p =.23). Subsequent hysterectomies were not decreased by endometrial ablation (p =.48) or by complete removal of the myoma (p =.83). Hysterectomies for bleeding problems were decreased by endometrial ablation. Pain and dysmenorrhea were a frequent cause of hysterectomy. CONCLUSION: Endometrial ablation at the time of hysteroscopic myomectomy improves results in the control of bleeding, (c) 2005 AAGL. All rights reserved.