Resumption of menstruation after amenorrhea in women treated by endometrial ablation and myometrial resection.

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.