Hysterectomy after Endometrial Ablation-Resection

Study Objective

To evaluate the reasons for performing a hysterectomy in patients who had previously undergone endometrial ablation-resection (EA-R), after a follow-up of at least 6 years.

Design

Retrospective study (Canadian Task Force classification II-3).

Setting

University-affiliated hospital.

Patients

Eighty-nine premenopausal women who underwent EA-R from February 1991 through February 2003.

Interventions

Endometrial ablation-resection by electrocoagulation using a rollerball of the uterine fundus and tubal ostia zone, and electroresection using a cutting loop of the rest of the uterine cavity.

Measurements and Main Results

During a minimum follow-up period of 6 years, hysterectomy was performed in 16 of 89 (17.97%) patients. In eight (9%) patients, hysterectomy was performed exclusively because of the failure of EA-R. The only factor that was related significantly to the increased possibility of requiring subsequent hysterectomy was the existence of myomas.

Conclusion

After long-term follow-up (more than 5 years), approximately one out of every five women who undergo EA-R will require a hysterectomy. The majority of these will be required during the first 2 years following EA-R. The existence of uterine myomas at the time of EA-R can be considered a risk factor for the subsequent need for hysterectomy.