Hysteroscopic endometrial ablation using free heated saline for the treatment of menorrhagia.

STUDY

OBJECTIVE

To assess the safety and efficacy of hysteroscopic endometrial ablation using controlled intrauterine instillation and circulation of heated (90 degrees C) saline.

DESIGN

Phase II clinical study (Canadian Task Force classification II-2).

SETTING

Preliminary study performed in an outpatient ambulatory surgery center of a university hospital.

PATIENTS: Twenty women with menorrhagia of benign causes.

INTERVENTION: Hysteroscopic endometrial ablation.

MEASUREMENTS AND MAIN

RESULTS

There were no complications. At no time did fluid leak from the fallopian tubes or cervix during treatment. Six patients had concurrent laparoscopy to measure serosal temperatures and to observe fimbriae directly during the 10-minute treatment. Serosal and endocervical temperatures were not elevated. Eighteen women kept evaluable menstrual diaries for 2 months before and 12 months after surgery. Ten women (55.6%) became amenorrheic, four (22.1%) hypomenorrheic, and three (16.7%) returned to normal periods after 12 months of follow-up. One woman (5.6%) reported a 75% decrease in menstrual flow but continued to be menorrhagic by definition. One patient subsequently underwent hysterectomy for simple endometrial hyperplasia.

CONCLUSION

This procedure appears to be a safe method of globally ablating the endometrium, resulting in effective treatment of menorrhagia.