A Prospective Study of Rollerball Endometrial Ablation in the Management of Refractory Recurrent Symptomatic Endometrial Hyperplasia without Atypia

Abstract

Backgrounds: Menorrhagia – heavy, extended or irregular menstruations – may be associated with endometrial hyperplasia. The aim of this study was to evaluate the clinical efficacy and safety of transcervical rollerball endometrial ablation (EA-R) and to discuss surgical outcomes in patients with simple endometrial hyperplasia without atypia who have had a history of medical treatment failure or recurrence. Methods: A prospective study was designed. Thirty women underwent EA-R. Preoperative and postoperative menstrual status, sexual activity, and satisfaction with the procedure were assessed. Complications, clinical outcomes, and need for re-intervention were evaluated. Results: No major complications occurred. All patients were discharged from hospital within 24 h. A reduction of menorrhagia was observed in patients as follows: 17 patients (56.67%) had amenorrhea, 10 (33.33%) hypomenorrhea, and 2 (6.67%) eumenorrhea. Hysterectomy was performed only in 1 patient who was unresponsive to ablation treatment. Conclusions: In selected patients who have persistent uterine bleeding not responsive to conservative therapy, low risk for future endometrial cancer, and wish to retain their uterus, EA-R treatment is safe, effective, and might be an alternative to hysterectomy with good toleration and high rate of patient satisfaction. The advantages of EA-R include low incidence of complications, lower morbidity, shorter hospitalization, and faster recovery.

Apoptotic Signaling Pathways in Uteri of Rats with Endometrial Hyperplasia Induced by Ovariectomy Combined with Estrogen

“…However, the alteration, role, and interaction of apoptotic signals in EH are unclear. Some studies that focused on endometrial carcinoma showed that the apoptotic signal is important in its development [18,19]. EH is the prelude of endometrial carcinoma.…”

Is There an Appropriate Cutoff Age for Sampling the Endometrium in Premenopausal Bleeding?

“…Abnormal uterine bleeding (AUB), which is the leading cause of gynecological visits, leads to anemia, fatigue and syncope due to blood loss, and has a negative impact on women's quality of life, daily activities and psychosocial life [1]. Also, it is the most common and the earliest symptom of endometrial cancer.…”