Endometrial destruction techniques for heavy menstrual bleeding

Lethaby, Anne; Hickey, Martha; Garry, Raymond

doi:10.1002/14651858.cd001501.pub2

Cited by 73 publications

(22 citation statements)

References 60 publications

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“…1 For over 20 years, endometrial ablation has been a treatment for menorrhagia as an alternative to hysterectomy and a number of techniques have subsequently been developed. 2 Endometrial ablation has since become an increasingly popular, minimally invasive outpatient treatment for symptomatic menorrhagia. The procedure can be performed under direct visualization via operative hysteroscopy, or by using thermal, laser, cryotherapy, or microwave instruments to destroy the endometrial lining.…”

Section: Discussionmentioning

confidence: 99%

Premature rupture of membranes, placenta increta, and hysterectomy in a pregnancy following endometrial ablation

et al. 2006

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Endometrial ablation has become a popular method of managing menorrhagia. Pregnancy after endometrial ablation has a high rate of complications. We present the case of a parous woman with a history of endometrial ablation with preterm premature rupture of membranes. Despite the absence of established sonographic markers for abnormal placentation, placenta accreta was noted at the time of cesarean delivery. In women with history of endometrial ablation, the endometrium is not normal and may allow for more aggressive placental invasion or adherence. Consequently, the sonographic indices described for evaluating placenta accreta may not be present. We believe that placentation in women with prior endometrial ablations should be considered extremely high risk for placenta accreta or increta and managed accordingly when preparing for delivery.

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Section: Discussionmentioning

confidence: 99%

Premature rupture of membranes, placenta increta, and hysterectomy in a pregnancy following endometrial ablation

et al. 2006

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“…Transcervical endometrial resection The wide use of a resectoscope in gynecological operations allowed its application as a method for treatment of DUB [42]. Transcervical endometrial resection (TCRE) has been shown to be an effective and safe method for treating DUB [43]. TCRE was tested in nonrandomized prospective studies, which reported a satisfaction rate between 85% and 87% and an amenorrhea rate varying up to 46% (Table 2) [44,45].…”

Section: First-generation Endometrial Ablation Techniquesmentioning

confidence: 99%

Treatment options for dysfunctional uterine bleeding: evaluation of clinical results

et al. 2011

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Abnormal uterine bleeding is one of the most common problems in women of reproductive age, and dysfunctional uterine bleeding (DUB) accounts for about half the cases. The aim of this review is to present all treatment options for women suffering from DUB and to evaluate their effectiveness. A detailed search strategy on electronic databases was carried out to identify trials and reviews on management of abnormal uterine bleeding. Tranexamic acid is the most effective medical treatment. A levonorgestrel-releasing intrauterine device is a low-cost, simple, and effective medical method, comparable to hysterectomy in terms of quality of life. In cases of DUB resistant to medical treatment, surgical treatment should be offered. First-generation ablation techniques are effective, but have a long learning curve. Second-generation ablation devices are highly effective and safe alternatives, thoroughly compared to first-generation techniques. Hysterectomy is the only method that guarantees treatment of dysfunctional uterine bleeding, but is a major operation associated with higher morbidity and mortality rates. Proper counseling of each woman with DUB regarding all treatment modalities can provide the best choice for each patient. More prospective randomized trials are needed to establish the effectiveness of these methods

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“…Although a whole number of methods are taken together and called the second generation, in reality it is a wide variety of different techniques: the hot liquid balloons, the microwave, bipolar ablation, phototherapy and chemical destruction of the endometrial lining. With the development of the second generation, operation time and hospitalisation became shorter, with a lower need for complimentary surgery following non satisfactory treatment and a higher satisfactory rate (Lethaby, 2009). …”

Section: Historymentioning

confidence: 99%

“…We have selected the most relevant randomized controlled trials with long term follow-up. The results are summarized in A large Cochrane Database review intensively studied and combined the studies comparing first and second generation techniques (Lethaby, 2009). The authors conclude that endometrial ablation offer a less invasive surgical alternative to hysterectomy.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%