A PROSPECTIVE-STUDY FOR A COMBINED HYSTER OSCOPIC LOCAL HORMONAL-THERAPY OF RECURRENT REFRACTORY HYPERMENORRHOEAS

In a prospective non-randomised study 26 patients suffering from refra ctory recurrent hypermenorrhoea had been treated by hysteroscopic endo metrial ablation. Insertion of levonorgestrel-IUD was performed postop erative in 13 patients. The purpose of the insertion was intrauterine contraception, increase of the postoperative rate of amenorrhoea, and prevention of an obliteration of the uterine cavity. An increased rate of amenorrhoea (92% vs. 54%) could be reached in comparison to a cont rol group of patients who were treated by endometrial ablation only. S imultaneous laparoscopic tubal sterilisation could be avoided by inser ting the IUD. These are the two main advantages of postoperative inser tion of a levonorgestrel-IUD with long-term action. This possibility o f simultaneous contraception during endometrial ablation is recommende d. Further studies are necessary to detect long-term results and a pos sible third positive postoperative effect (prevention of post-ablation syndromes).