Retrospective analysis of 305 consecutive cases of endometrial ablation and partial endomyometrial resection

Study Objective. To assess the efficacy and safety of operative resectoscopy, partial endomyometrial resection, and endometrial ablation in the evaluation and treatment of abnormal uterine bleeding. Design. Retrospective analysis of 305 consecutive cases of endometrial ablation and partial endomyometrial resection. Setting. Midwestern urban obstetric and gynecology group practice and teaching hospitals. Patients. Three hundred five women (age 30-72 yrs) with abnormal uterine bleeding. interventions. Partial endomyometrial resection and endometrial ablation. Measurements and Main Results. Of the 301 patients who completed surgery and follow-up, 283 (97%) reported improvements in amenorrhea (55%), hypomenorrhea (41%), and eumenorrhea (1%). Ten (3%) failed to report improvement. In 24 (7.9%) women, hysterectomy was performed for various reasons after endometrial ablation, including recurrent bleeding in 4. Four uterine perforations occurred, infection was suspected in one patient, and loss of Laminaria occurred in another; all patients, however, were observed appropriately and discharged the same day of surgery. Conclusions. Partial endomyometrial resection and endometrial ablation is a safe and effective treatment of abnormal uterine bleeding, and may be an alternative to hysterectomy in selected patients.