ENDOMETRIAL ABLATION WITH A VAPORIZING ELECTRODE - II - CLINICAL OUTCOME OF A PILOT-STUDY

Background. As a vaporizing electrode has been successfully used to tr eat submucous myomas, we evaluated its safety and efficacy in performi ng endometrial ablation. Methods. Forty consecutive women with establi shed menorrhagia with (n=26) and without (n=14) submucous myomas were enrolled in a prospective, noncomparative, pilot study. Hysteroscopic endometrial vaporization was performed with pure cutting current set a t 200 watts. Results. All procedures were completed without complicati ons. Median (interquartile range, IQR) fluid deficit was 90 (0-200) ml and median (IQR) operating time 10 (7-12.5) min. A significant correl ation was observed between operating time and fluid absorption (Spearm an's test by ranks, r=0.47; p=0.002). The degree of difficulty of the operation was classified as none on 28 (70%) occasions, mild on 11 (27 .5%) and moderate on one (2.5%). After a mean +/- s.d. follow-up of 20 .3 +/- 2.4 months, amenorrhea or spotting were reported by 23 (57.5%) subjects, hypomenorrhea by 10 (25%), normal flows by six (15%), and me norrhagia by one (2.5%). The median (IQR) menstrual score calculated a ccording to a pictorial blood loss assessment chart dropped from 282.5 (199-383) to 0 (0-15) (p<0.0001). Six (15%) subjects were very satisf ied with the effect of surgery, 30 (75%) satisfied, two (5%) uncertain , one (2.5%) dissatisfied and one (2.5%) very dissatisfied. Conclusion s. The vaporizing electrode seems to combine the benefits of the cutti ng loop (speed, efficacy and possibility of removing myomas) and the r oller-ball electrode (safety and limited fluid absorption) while avoid ing their respective disadvantages, and may be considered an interesti ng alternative in the hysteroscopic treatment of menorrhagia.