Endometrial laser intrauterine thermotherapy: the first series of 100 patients observed for 1 year

Objective: To describe a new instrument (GyneLase (R)) that offers a new ap proach (endometrial laser intrauterine thermal therapy [ELITT]) to treatmen t of menorrhagia and to evaluate the efficacy of ELITT in the management of dysfunctional uterine bleeding. Design: Prospective study. Setting: University hospital. Patient(s): 100 premenopausal women with dysfunctional uterine bleeding wer e observed for 1 year. Intervention(s): Intrauterine laser thermotherapy with a diode laser. Main Outcome Measurement(s): Amenorrhea rate after 1 year. Result(s): The amenorrhea rate after 1 year of follow-up was 71%, and the r ate of amenorrhea/severe hypomenorrhea rate was >90%; these rates are much higher than those in the literature after such procedures as electrosurgery or intrauterine thermal balloon therapy. The ELITT procedure is an inheren tly safe and simple alternative, providing controlled and effective treatme nt of the entire endometrium. In contrast to traditional endometrial ablati on using a neodymium yttrium-aluminum-garnet laser, the ELITT procedure doe s not require intensive training or hysteroscopic control; it is also far l ess risky, because the power used per unit area is 1,000 times lower. Conclusion(s): The ELITT procedure is a new nonhysteroscopic technique for endometrial ablation. The technique is very safe and offers the highest ame norrhea rate to date in the literature. (Fertil Steril (R) 2000;74: 791-6. (C) 2000 by American Society for Reproductive Medicine.).