These results suggest that patients with a history of GBS are at a significantly higher risk of GBS recolonization in subsequent pregnancies.

Endometrial ablation procedures are extensively used for the treatment of menorrhagia on premenopausal patients who failed medical therapy. The increasing popularity of safe, effective, less invasive, nonresectoscopic global endometrial ablation procedures could potentially increase the incidence of unusual adverse outcomes. Postablation tubal sterilization (PATSS) is one of these delayed complications, which could be challenging to diagnose. PATSS is a complication that potentially occurs following a global endometrial ablation in women with previous tubal sterilization. PATSS presents as cyclic pelvic pain caused by tubal distention from occult bleeding into the obstructed tubes. Review of the literature shows that majority of PATSS occurred after rollerball resection and ablation. We report two cases of PATSS after NovaSure® radiofrequency endometrial ablation.Keywords Post-ablation tubal sterilization syndrome, PATSS . Novasure . Endometrial ablation . Tubal ligation . Pelvic pain Case report no. 1A 47-year-old woman (gravida 3, para 3) had a 4-year history of cyclic pelvic pain primarily on the left side. Due to a long history of menorrhagia with resulting anemia, in spite of medical therapy, the patient underwent an endometrial ablation in 2007 using NovaSure® radiofrequency energy (Hologic, USA). The patient had a laparoscopic tubal ligation with bipolar coagulation in 1993 with another provider. The patient was referred by her primary care physician because of the patient's complaints of chronic pelvic pain and severe dysmenorrhea, which started a few months after the Novasure® endometrial ablation. The pelvic ultrasound showed a 2.0-cm left-sided hydrosalpinx, but the right ovary was not identified. The patient had an unremarkable medical and gynecological history.Physical examination revealed a soft abdomen without rebound or guarding. Bimanual examination showed a normal-size uterus but elicited cervical motion tenderness and bilateral adnexal tenderness primarily on the left side. Her vital signs were stable.Laboratory results showed a normal white blood cell count and urinalysis. Serum pregnancy test was negative. Genital cultures with gonorrhea and chlamydia were negative.On laparoscopy, both tubes were approximately 2-0-cm dilated. The uterus and bilateral ovaries appeared normal. The left hydrosalpinx was identified (Fig. 1). Endometrial lesions were absent. Laparoscopic bilateral salpingectomy and pelvic adhesiolysis were performed using Gyrus PKS™ advanced bipolar forceps.She was discharged home the same day, and her postoperative course was without incident. The final pathological diagnosis reported bilateral sterile hydrosalpinx. Case report no. 2A 42-year-old woman (gravida 3, para 3) presented to the Emergency Department with complaints of right lower quadrant pain, watery vaginal discharge, fever, and chills. The patient had NovaSure endometrial ablation 6 weeks