RESUMENIntroducción: El sangrado uterino anormal (SUA) afecta a un 19% de las mujeres. Su tratamiento definitivo consiste en la histerectomía, sin embargo la ablación endometrial histeroscópica surge como un tratamiento menos invasivo, menos riesgoso y más rápido. Objetivo: Evaluar la efectividad de la ablación endometrial histeroscópica como tratamiento definitivo para el SUA. Método: Estudio de cohorte retrospectivo obtenido de base de datos de protocolos operatorios específicos del total de histeroscopías quirúrgicas realizadas en el Servicio de Ginecología del Hospital Naval Almirante Nef de Viña del Mar, entre enero de 2002 y diciembre de 2010. Resultados: De las 507 histeroscopías quirúrgicas realizadas, 230 fueron por SUA. Del total de pacientes sometidas a ablación endometrial histeroscópica, 27 (11,7%) necesitaron un segundo procedimiento, de las cuales sólo 15 (6,5%) fueron por persistencia de SUA. No se encontró asociación entre la necesidad de un segundo procedimiento por SUA con características propias de la paciente ni del procedimiento quirúrgico. Conclusión: La ablación endometrial histeroscópica es una opción terapéutica efectiva y segura para el tratamiento del SUA, con baja necesidad de segundo procedimiento por persistencia de éste y bajo riesgo de complicaciones. La necesidad de un segundo procedimiento por SUA no se asocia con características propias de la paciente ni del procedimiento quirúrgico. PALABRAS CLAVE: Sangrado uterino anormal, ablación endometrial histeroscópica, histerectomía SUMMARYIntroduction: Abnormal uterine bleeding (AUB) affects 19% of women. Definitive treatment is hysterectomy, however hysteroscopic endometrial ablation is emerging as a less invasive, less risky and faster treatment. Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation as definitive treatment for AUB. Method: Retrospective cohort study database obtained from specific surgical protocols of all surgical hysteroscopies performed in the Gynecology Department of Hospital Naval Almirante Nef de Vina del Mar, between January 2002 and December 2010. Results: Of the 507 surgical hysteroscopies performed, 230 were because of AUB. Of all patients undergoing hysteroscopic endometrial ablation, 27 (11.7%) required a second procedure, of which only 15 (6.5%) were due to persistence of AUB. No association was found between the need for a second procedure because of AUB with patient characteristics or the surgical procedure itself. Conclusion: Hysteroscopic endometrial ablation is a safe and effective therapeutic option for AUB treatment, with a low need for a second procedure due to its persistence and with low risk of complications. The need of a second procedure because of AUB is not associated with patient characteristics or the surgical procedure itself.
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