A historical perspective on the issue of device-based endometrial destruction is presented. The article describes in detail various current methods of thermal coagulation of the uterine mucosa for its destruction. A comparative analysis of hysteroscopic and non-hysteroscopic methods of endometrial destruction in terms of treatment effectiveness, complications, and recurrence prevention is presented. The ways of technological development of instrumental treatment methods of intrauterine disorders are highlighted.
The aim of the study is to compare the effectiveness of the use of hormonal drugs before hysteroresectoscopic ablation of the endometrium in premenopausal patients with abnormal uterine bleeding. Were examined 145 women aged from 45 to 54 years with recurrent endometrial hyperplasia, which were divided into three groups depending on the preoperative use of one of the hormonal drugs (gestagen preparation, microdose estrogen-gestagen contraceptive, gonadotropin-releasing hormone agonist - GnRHa). When medication-induced endometrial atrophy was achieved, the patients underwent hysteroresectoscopic endometrial ablation using the coagulation vaporization technique. The results of the study showed the feasibility of preoperative thinning of the uterine mucosa to improve the results of treatment of its benign changes. The most effective means for accelerating the attainment of drug regression of the endometrium were GnRHa, whose effectiveness was 95.7%. The estrogen-gestagen-containing contraceptive and gestagen preparation showed an efficacy of 65.3% and 42.8%, respectively. The results of the study should be considered when choosing the optimal tactics for management of premenopausal patients with abnormal uterine bleeding.
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