Prediction of endometrial ablation success according to perioperative findings

OBJECTIVE: The aim of this study was to determine which factors in the peri operative period influence the success of endometrial ablation in alleviati ng menorrhagia. STUDY DESIGN: We performed a retrospective chart review of 120 women aged 2 7 to 49 years who underwent endometrial ablation after 2 months of preopera tive treatment with danazol (Danocrine, 800 mg/d orally) or leuprolide (Lup ron, 3.75 mg in one intramuscular injection each month). Patients who requi red medical management or additional operations to control the vaginal blee ding during Follow-up (median follow-up, 37 weeks) were considered to have ablation failures. RESULTS: Sixty-three percent of patients (76/120) had a successful procedur e. The chance of success was greater ii a cavity of normal appearance was f ound (odds ratio, 2.3; P=.04). The finding of an intramural fibroid before the procedure resulted in a reduced trend toward success (odds ratio, 0.4; P=.06). The use of danazol pretreatment improved the rate of success overal l (odds ratio, 2.2; P=.05) and especially among women <40 years old (PI.01) CONCLUSION: Perioperative findings may provide useful information in counse ling patients regarding endometrial ablation. Success is greater among pati ents with a normal intrauterine cavity and after preoperative treatment wit h danazol.