The Journal of the American Association of Gynecologic Laparoscopists · 1997
Resumption of menstruation after amenorrhea in women treated by endometrial ablation and myometrial resection.
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Seeras R C, Gilliland G B
Аннотация
STUDY OBJECTIVE: To evaluate the prevalence of resumption of menstruation after an interval of amenorrhea in women treated by endometrial ablation and myometrial resection.
DESIGN: Retrospective analysis.
SETTING: Tertiary care university-affiliated teaching hospital.
PATIENTS: One hundred fifty-seven consecutive patients treated for menorrhagia refractory to medical therapy.
INTERVENTIONS: Loop resection or rollerball ablation of the endometrium.
MEASUREMENTS AND MAIN RESULTS: At 6 to 12 months postoperatively, 50. 6% of patients were amenorrheic and 35.1% had hypomenorrhea. Over follow-up of 13 to 30 months, 45.1% of women became amenorheic and 40.5% had satisfactory hypomenorrhea. Resumption of menstruation after any interval of amenorrhea occurred in 27.2% of amenorheic patients. We observed an increasing trend to resumption of menstruation after rollerball ablation (29.4%) compared with loop resection (26.7%) and after preoperative endometrial suppression with buserelin (37.5%) and leuprolide (27.1%) compared with danazol (12.5%) and goserelin (10.5%). Resumption of menstruation occurred in 44.4% of women who did not have preoperative endometrial suppression.
CONCLUSIONS: Our results suggest that resumption of menstruation does occur after a variable interval of amenorrhea following endometrial ablation and myometrial resection. It could potentially be used as a marker of failure of endometrial destruction.
DESIGN: Retrospective analysis.
SETTING: Tertiary care university-affiliated teaching hospital.
PATIENTS: One hundred fifty-seven consecutive patients treated for menorrhagia refractory to medical therapy.
INTERVENTIONS: Loop resection or rollerball ablation of the endometrium.
MEASUREMENTS AND MAIN RESULTS: At 6 to 12 months postoperatively, 50. 6% of patients were amenorrheic and 35.1% had hypomenorrhea. Over follow-up of 13 to 30 months, 45.1% of women became amenorheic and 40.5% had satisfactory hypomenorrhea. Resumption of menstruation after any interval of amenorrhea occurred in 27.2% of amenorheic patients. We observed an increasing trend to resumption of menstruation after rollerball ablation (29.4%) compared with loop resection (26.7%) and after preoperative endometrial suppression with buserelin (37.5%) and leuprolide (27.1%) compared with danazol (12.5%) and goserelin (10.5%). Resumption of menstruation occurred in 44.4% of women who did not have preoperative endometrial suppression.
CONCLUSIONS: Our results suggest that resumption of menstruation does occur after a variable interval of amenorrhea following endometrial ablation and myometrial resection. It could potentially be used as a marker of failure of endometrial destruction.