Complete amenorrhea after treatment of resistant menorrhagia using NovaSure ablation

Abstract

Introduction: Heavy menstrual bleeding (HMB) or menorrhagia is the most common form of dysfunctional uterine bleeding (DUB). In spite of medical treatment for DUB, many women will eventually require a hysterectomy, which is an invasive treatment option. NovaSure ablation offers a same-day non-invasive alternative to hysterectomy and hysteroscopic ablation. Case description: A 38-year-old woman presented with HMB in 2015. The attacks of HMB interrupted her lifestyle , and she refused to continue with medical treatment, which failed to resolve her symptoms. The patient was admitted to the hospital four times in 2015, due to anemia caused by the DUB. Medroxyprogesterone acetate and oral contraceptive pills failed to control the patient's bleeding episodes. Hysteroscopic examination of the uterine cavity showed a normal cavity, and the endometrial biopsy showed proliferative endometrium. She was counseled about NovaSure ablation as the last treatment option before hysterectomy. The NovaSure ablation procedure took 90 s, and the patient was discharged from the hospital 6 h after the procedure. At follow-up, the patient is completely amenorrheic, and she is satisfied with the NovaSure ablation results. Conclusions: This case report demonstrates that NovaSure endometrial ablation is a safe, effective, non-invasive alternative to hysteroscopic endometrial ablation for treatment of DUB.

Severe adenomyosis with unexpectedly high CA-125: report of a rare case

“…The studied woman was surgically managed by total hysterectomy and bilateral salpingectomy with bilateral ovarian conservation (because of her age of 46 years and both normal ovaries detected by pre-operative MRI and intra-operative examination) after correction of her anemia using intravenous iron, departmental approval and the patient’s consent. The decision of hysterectomy was based on failed cyclic progesterone with tranexamic acid over the last 3 months to control the studied woman’s bleeding attacks [ 5 ] and presence of cystic glandular hyperplasia detected after histological examination of the endometrial biopsy taken during the therapeutic curettage.…”

“…She had received cyclic progesterone (cyclic medroxyprogesterone acetate 10 mg daily for 10 days each month) with tranexamic acid (anti-fibrinolysis) 1-1.5 g 3 times/day during the bleeding episodes for the last 3 months without any response [ 5 ].…”