Intracavitary radiotherapy for refractory dysfunctional uterine bleeding -A case report

BACKGROUND: Pelvic irradiation was once a common treatment for dysfunctiona l uterine bleeding (DUB). Today the majority of women with DUB are successf ully treated with hormonal therapy; patients unresponsive to hormonal thera py may require endometrial ablation or hysterectomy. We present a patient w ith severe, intractable DUB and contraindications to surgery who was treate d wit intracavitary radiotherapy. CASE: A 39-year-old, 150-cm-tall, 310-kg woman was referred for management of severe DUB refractory to medical management. The bleeding was successful ly treated wit intracavitary cesium. Hysterectomy was not recommended due t o the operative risks posed by the patient's massive obesity. Because of te chnical difficulties during a previous dilation and curettage and the expen se of long-term GnRH agonist therapy, the patient elected to undergo intrac avitary radiotherapy. CONCLUSION: In selected patients, intracavitary radiotherapy can be used to treat DUB when conventional therapy fails or is contraindicated.