Hormonal inhibition of endometrium for transcervical endometrial ablation - a prospective study with a 2-year follow-up

Objective: To determine the best pretreatment of the endometrium prior to roller ball endometrial ablation. Study Design: Forty patients with recurrent hypermenorrhea underwent diagnostic hysteroscopy and dilatation and curettage. They were then assigned to receive either no pretreatment or pretreatment with danazol, a GnRH-analogue, or a gestagen prior to roller ball endometrial ablation. Endometrial suppression was estimated by the surgeon at the time of the procedure, and endometrial biopsies were obtained. Patients were followed for 24 months. Results: The subjective estimation of the surgeon showed a sufficient pretreatment after danazol or a GnRH-analogue in 90% of the cases. Histological findings correlated with these findings. The highest level of amenorrhoea at 2 years of follow-up was also reached after danazol or GnRH-analogue pretreatment. Conclusions: Danazol-or GnRH analogue should be used for pretreatment prior to endometrial ablation using the roller ball technique. (C) 1997 Elsevier Science Ireland Ltd.