1/32. Balloon endometrial ablation as a safe alternative to hysterectomy.Each year, 600,000 hysterectomies are performed in the united states, costing an estimated $4 billion. Approximately 50% of these hysterectomies are performed for menorrhagia or abnormal uterine bleeding. menorrhagia can have a negative impact on a woman's lifestyle and self-perception, often leading her to seek definitive treatment. Pharmacologic treatment for menorrhagia is not always successful, and dilatation and curettage provides relief for only the first few menstrual cycles. Surgical options include hysterectomy and two forms of endometrial ablation. Current research demonstrates that thermal uterine balloon therapy is the safest of these options. Uterine balloon therapy, an outpatient procedure, has resulted in successful reduction in menstrual flow in 70% to 90% of patients, and it soon may be performed as an office-based procedure.- - - - - - - - - - ranking = 1keywords = endometrial ablation, ablation (Clic here for more details about this article) |
2/32. Successful use of recombinant VIIa (Novoseven) and endometrial ablation in a patient with intractable menorrhagia secondary to FVII deficiency.menorrhagia is a well-recognized complication of inherited bleeding disorders. In the past, the only viable option for women who were unresponsive to medical therapy was hysterectomy. Endometrial ablation has been recently developed as an alternative therapy for these patients and is associated with decreased morbidity. We report the successful use of activated recombinant factor vii (FVIIa) and endometrial ablation in the treatment of excessive menstrual blood loss in a 34-year-old women with severe factor vii (FVII) deficiency. Recombinant FVIIa (40 microg/kg) was administered pre-operatively and every 6 h (20 microg/kg) for 24 h postoperatively. The procedure was uncomplicated with a 200 ml surgical blood loss. FVIIa was used because it allowed FVII replacement with a recombinant product and also has the ability to bind to tissue factor expressed at the site of vascular injury, resulting in site-specific thrombin generation. We believe that endometrial ablation with recombinant VIIa should be considered in patients with severe FVII deficiency and menorrhagia unresponsive to medical therapy.- - - - - - - - - - ranking = 1.2001332692597keywords = endometrial ablation, ablation (Clic here for more details about this article) |
3/32. Endometrial stromal sarcoma diagnosed after hysteroscopic endometrial resection.Endometrial ablation and resection is now common therapy for dysfunctional uterine bleeding that is unresponsive to conservative management. Opponents argue that it may predispose patients to potentially hazardous malignancies of the uterus. In our patient, endometrial resection was performed to treat menorrhagia after a negative workup. Pathologic interpretation of the resected tissue showed a low-grade stromal sarcoma of the endometrium. The woman underwent definitive treatment, which included total abdominal hysterectomy, and has remained recurrence free over the past 3 years. Although rare, uterine malignancies have been documented after hysteroscopic management of menorrhagia. It is suggested that intraoperative endometrial resection or tissue sampling be done to prevent or diagnose endometrial hyperplasia and uterine malignancies.- - - - - - - - - - ranking = 0.0001332692596694keywords = ablation (Clic here for more details about this article) |
4/32. Severe menorrhagia due to Glanzmann thrombasthenia treated with hydrothermal ablation.Glanzmann thrombasthenia is a rare platelet disorder inherited as an autosomal recessive trait. Abnormal uterine bleeding is a common problem in women with the disease. Medical management may not always be effective and further treatment may be necessary. Two women underwent endometrial ablation with a continuous-flow circulating hydrothermal ablator. After follow-up of 12 and 18 months, both women remained without abnormal uterine bleeding.- - - - - - - - - - ranking = 0.20053307703868keywords = endometrial ablation, ablation (Clic here for more details about this article) |
5/32. Hysteroscopic appearance of the uterine cavity before and after microwave endometrial ablation.STUDY OBJECTIVE: To evaluate the appearance of the uterine cavity before and after microwave endometrial ablation (MEA). DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: University teaching hospital. patients: Sixty-two women with menorrhagia. INTERVENTION: Hysteroscopic examination the uterine cavity before and after MEA. MEASUREMENTS AND MAIN RESULTS: Ablation was complete in 55 patients (group A). Seven women had a small island of intact endometrium (group B); the uterine cavity was severely distorted in six of these patients due to submucous myomas in five and adenomyosis in one. Another patient in this group had an acutely retroverted uterus, a 15-mm intramural myoma, and a normal uterine cavity. women in group B had deeper uterine cavity than those in group A (101.4 /- 15.5 and 84.7. /- 12.8 mm, respectively, p = 0.008). The duration of ablation was also longer in group B (329.1 /- 158.4 sec) than in group A (206.1 /- 67.4 sec, p = 0.01). CONCLUSION: Microwave endometrial ablation tends to be incomplete in women with a large and severely distorted uterine cavity. Whether, this results in a lower success rate remains to be seen. (J Am Assoc Gynecol Laparosc 8(1):83-86, 2001)- - - - - - - - - - ranking = 1.2001332692597keywords = endometrial ablation, ablation (Clic here for more details about this article) |
6/32. Successful planned pregnancy following endometrial ablation with the YAG laser.In selected patients who previously have undergone YAG laser ablation of the endometrium and who have demonstrated normal intrauterine architecture, pregnancy as a planned event may be a reasonable and safe option.- - - - - - - - - - ranking = 0.80013326925967keywords = endometrial ablation, ablation (Clic here for more details about this article) |
7/32. menorrhagia and adenomyosis in a patient with hyperhomocysteinemia, recurrent pelvic vein thromboses and extensive uterine collateral circulation treatment by supracervical hysterectomy.A 37-year-old patient had recurring thromboses, occlusion of the left femoral vein with hereditary hyperhomocysteinemia, hypermenorrhea and anaemia. Conservative therapy with endometrium ablation and gestagene failed. A supracervical hysterectomy was done to preserve the presacral and left lateral, dorsal and caudal collaterals beside the uterus, and prevent a postoperative congestion, especially of the left leg.- - - - - - - - - - ranking = 0.0001332692596694keywords = ablation (Clic here for more details about this article) |
8/32. hematometra after thermal balloon endometrial ablation in a patient with cervical incompetence.BACKGROUND: Thermal balloon endometrial ablation is a relatively safe nonsurgical treatment for menorrhagia. hematometra follows this procedure in <3 % of patients, but risk factors for this complication are unclear. CASE: A woman with a history of cervical incompetence during pregnancy later developed cervical occlusion and hematometra after thermal balloon endometrial ablation. Cervical occlusion did not recur after cervical dilatation and temporary placement of a catheter as a stent. CONCLUSION: The normal resistance of the internal cervical os may be an important factor in avoiding thermal damage to the cervix during thermal balloon endometrial ablation. This case suggests that a history of cervical incompetence may be a clinical indicator of decreased cervical resistance.- - - - - - - - - - ranking = 1.4keywords = endometrial ablation, ablation (Clic here for more details about this article) |
9/32. Endometrial balloon ablation as a therapy for intractable uterine bleeding in an adolescent.STUDY OBJECTIVE: To evaluate the use of a minimally invasive global endometrial ablation technique in the management of life-threatening bleeding unresponsive to hormonal treatment. RESULTS: Immediate cessation of bleeding with recovery of normal hematologic profile. CONCLUSIONS: Endometrial ablation by global balloon ablation may be considered an alternative to hysterectomy in life-threatening hemorrhage in the adolescent patient who is unresponsive to hormonal therapy.- - - - - - - - - - ranking = 0.20079961555802keywords = endometrial ablation, ablation (Clic here for more details about this article) |
10/32. Balloon thermoablation in a woman with complex endometrial hyperplasia with atypia. A case report.BACKGROUND: Endometrial ablation is an alternative to hysterectomy in patients with menorrhagia refractory to medical therapy. The histologic changes in the hyperplastic endometrium secondary to endometrial ablation are not well understood. CASE REPORT: A 44-year-old woman, gravida 4, para 4, had menorrhagia, was at high risk for medical treatment and underwent thermal balloon ablation. The dilatation and curettage specimen at the time of the procedure revealed complex hyperplasia of the endometrium with atypia. Subsequently a hysterectomy was performed, and the pathology specimen showed scarring, fibrosis and focal, weakly proliferative phase endometrium. There was no evidence of hyperplasia or malignancy. CONCLUSION: Endometrial ablation with a thermal balloon seems to have resulted in resolution of endometrial hyperplasia. However, hyperplasia of the endometrium should still be a contraindication to such a procedure because of the inability to accurately assess the endometrium after ablation.- - - - - - - - - - ranking = 0.20106615407736keywords = endometrial ablation, ablation (Clic here for more details about this article) |
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