Long-term complications of endometrial ablation: Cause, diagnosis, treatment, and prevention

McCausland, Arthur M.; McCausland, Vance M.

doi:10.1016/j.jmig.2007.04.004

Cited by 100 publications

(59 citation statements)

References 36 publications

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“…Endometrial cancer is associated with type II diabetes mellitus, obesity, hypertension, colon cancer, anovulatory syndromes such as polycystic ovarian syndrome, history of endometrial hyperplasia, and failure of progestin treatment of any cause of AUB. 38,39 Patients considering EA should be counseled appropriately, and EA should be avoided in patients with high risk of EC. Patients must be counseled about the lower likelihood of successful endometrial biopsy, if it is indicated after EA.…”

Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

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). © 2011 Mayo Foundation for Medical Education and ResearchB reast cancer is the leading cause of cancer death in women in the United States who are aged 20 to 59 years. 1 In 2010, an estimated 207,090 new cases of breast cancer were identified in the United States. 2 Although breast cancer risk increases with age, approximately 35% of breast cancers occur during the reproductive and perimenopausal years. 3 The 5-year relative survival rate for women of all ages with breast cancer diagnosed between 1999 and 2005 is 89%. 3 Of the premenopausal breast cancers diagnosed, approximately 58% are both estrogen receptor (ER) and progesterone receptor (PR) positive, 6% are ER positive only, 17% are PR positive only, and 20% are both ER and PR negative. 4 The management and treatment of breast cancer in premenopausal women can affect menstruation, reproduction, and gynecologic health. Breast cancer treatment can have a marked affect on fertility in women who have delayed childbearing and have fewer remaining reproductive years. Among premenopausal women with breast cancer, more than 50% wish to retain their fertility. 5 AUB = abnormal uterine bleeding; E2 = estradiol; EA = endometrial ablation; EC = endometrial cancer; ER = estrogen receptor; FDA = Food and Drug Administration; GnRH = gonadotropin-releasing hormone; IUD = intrauterine device; LNG = levonorgestrel; NSAID = nonsteroidal anti-inflammatory drug; PR = progesterone receptor; SHBG = sex hormone-binding globulin gynecologic issues and conditions are prevalent in reproductive-age women. In the general population, more than 30% of reproductive-age women fulfill criteria for the diagnosis of menorrhagia, 6 25% have symptomatic fibroids, 7 and nearly 67% have an underlying uterine disorder with potential to cause abnormal uterine bleeding (AUB). 8 Among premenopausal women with breast cancer, management of menstrual disorders, contraception, vasomotor symptoms, and fertility presents a challenge. Common and effective hormonal options are less well studied in this population because of significant concern about recurrence of breast cancer. Herein,we present the challenges and discuss management options for young women with breast cancer who present with various common gynecologic conditions.Articles for this review were identified by searching the PubMed database with no date limitations. PREMENoPAUSAL SEx STERoIDS AND THEIR PHARMACoLoGyPhysiologically, premenopausal women with regular cycles have cyclic variation in levels of estradiol (E2) (15-350 pg/ mL [to convert to pmol/L, multiply by 3.671]) and progesterone (0.2-27 ng/mL [to convert to nmol/L, multiply by 3.18]). These "free" (unbound) hormones are biologically active and can enter a target cell and activate its receptor.

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Section: Aub Caused By Anatomic Abnormalitiesmentioning

confidence: 99%

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Bakkum-Gamez

Laughlin

Jensen

et al. 2011

Mayo Clinic Proceedings

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“…El estudio anatomopatológico de las piezas de histerectomía informó en los 3 casos de adenomiosis. McCausland AM et al 18 señalan que el hematómetra puede estar causado por sinequias y por la persistencia de islotes de endometrio, que además pueden penetrar en el miometrio y dar lugar a adenomiosis, habiendo encontrado este diagnóstico en un 20% de estas mujeres.…”

Section: Discussionunclassified

Ablación-resección endometrial con resectoscopio monopolar: resultados

Romero

Guadix

et al. 2016

Clínica e Investigación en Ginecología y Obstetricia

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“…In our study, 75% of women had a pelvic ultrasound performed preoperatively, but only 40% of these confirmed the presence of a haematometra. However, studies have shown that magnetic resonance imaging is probably superior at detecting small haematometra than ultrasound scans and that all scans are best done when the patient is symptomatic as the haematometra can resolve during the rest of the cycle [10]. More studies looking at preoperative diagnosis of these complications may help determine which group of patients may benefit from hysteroscopic adhesiolysis.…”

Section: Discussionmentioning

confidence: 99%

“…It may be that our pathologists did not specifically look for evidence of cornual haematometra or PATSS as they were not aware of this complication. It has been suggested that pathologists need to be specifically asked to serially section the cornual areas of the uterus and the proximal fallopian tubes in these women to diagnose these conditions; however, they may still be missed if the patient is not symptomatic at the time of the hysterectomy [10].…”

Section: Discussionmentioning

confidence: 99%

Pelvic pain following microwave endometrial ablation—is hysteroscopic adhesiolysis worthwhile?

Allen

Phillips

2008

Gynecol Surg

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A proportion of patients present with chronic pelvic pain following microwave endometrial ablation, presumed to be due to the development of a haematometra. This retrospective observational study of 20 patients was performed to determine if hysteroscopy and adhesiolysis is beneficial in this group of patients. Seventeen patients were found to have intrauterine adhesions at hysteroscopy that were divided. At follow-up, nine patients were cured of pain and discharged. Of the remaining 11 patients, one patient with endometriosis underwent laparoscopic bilateral salpingo-oophorectomy. Nine patients underwent hysterectomy and one patient was put on mefenamic acid. In conclusion, some patients were still symptomatic following hysteroscopy and needed further intervention in the form of major gynaecological surgery. However, 45% of patients improved following only the minor day case procedure, without needing to resort to a hysterectomy with its inherent risks and costs.

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Long-term complications of endometrial ablation: Cause, diagnosis, treatment, and prevention

Cited by 100 publications

References 36 publications

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

Ablación-resección endometrial con resectoscopio monopolar: resultados

Pelvic pain following microwave endometrial ablation—is hysteroscopic adhesiolysis worthwhile?

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