Sonographic Findings in Postmenopausal Women With a Prior Endometrial Ablation: Interpretation and Management of Women With Endometrial Thickening and Bleeding

Morelli, Michele; Rocca, Morena; Mocciaro, Rita; Cello, Annalisa Di; Sacchinelli, Angela; Trana, E. De; Cariati, Francesco; Venturella, Roberta; Zullo, Fulvio

doi:10.1016/j.jmig.2014.12.164

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…After duplicates were removed, 734 publications were left for assessment. Eventually, 11 articles were included in the systematic review on incidence of endometrial cancer after endometrial ablation; nine retrospective studies, one prospective cohort study, and one randomized controlled trial 3 13–16 22–27. Twenty-four articles were included describing a total of 38 individual cases of endometrial cancer after ablation 3 11 13–15 22–25 27–41.…”

Section: Resultsmentioning

confidence: 99%

“…According to the incidence data from 10 cohort studies and one randomized controlled trial, 29 102 patients after endometrial ablation were followed up for a period until 25 years after ablation (Table 1). 3 13–16 22–27 The incidence of endometrial cancer after endometrial ablation varied from 0.0% to 1.6%.…”

Section: Resultsmentioning

confidence: 99%

“…From our extensive search, 24 articles were included describing single or multiple cases of endometrial cancer after ablation 3 11 13–15 22–25 27–41. In total 38 cases were described.…”

Section: Resultsmentioning

confidence: 99%

“…A potential problem could be the decrease in sensitivity of ultrasound features after ablation because of changes in the endometrium and difficulties in recognition of the endometrial thickness. Furthermore, difficulties in endometrial sampling due to intrauterine adhesions might be expected 3 13–16…”

Section: Introductionmentioning

confidence: 99%

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Endometrial cancer after endometrial ablation: a systematic review

Oderkerk

Kar

Cornel

et al. 2022

Int J Gynecol Cancer

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ObjectiveTo investigate whether a previously performed endometrial ablation is associated with the development and diagnosis of endometrial cancer.MethodsFirst, a systematic review was performed of the articles reporting the incidence of endometrial cancer in patients treated with endometrial ablation. Second, a systematic review was performed to identify all individual cases of endometrial cancer after ablation to evaluate presenting symptoms, diagnostic work-up, potential risk factors, and the type and stage of the endometrial cancer. A systematic search was performed, using Medline, EMBASE, and the Cochrane Library databases, from inception through February 24, 2022.ResultsBased on 11 included studies, the incidence of endometrial cancer in a population of 29 102 patients with a prior endometrial ablation ranged from 0.0% to 1.6%.A total of 38 cases of endometrial cancer after ablation were identified. In 71% of cases (17 of 24 cases), vaginal bleeding was the first presenting symptom. With transvaginal ultrasound it was possible to identify and measure the endometrial thickness in eight cases. Endometrium sampling was successful in 16 of 18 described cases (89%). In 18 of 20 cases (90%) pathologic examination showed early-stage endometrioid adenocarcinoma (International Federation of Gynecology and Obstetrics stage I).ConclusionPrevious endometrial ablation is not associated with the development of endometrial cancer. Diagnostic work-up is not impeded by previous endometrial ablation. In addition, endometrial cancers after endometrial ablation are not detected at an advanced stage.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endometrial cancer after endometrial ablation: a systematic review

Oderkerk

Kar

Cornel

et al. 2022

Int J Gynecol Cancer

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“…Our observations support the contention by Ahonkallio et al 21 that traditional means of evaluating the endometrial cavity are often obviated, or at least challenging, in the postablation population. The limitations of sonography as a screening tool for postablation EC has been addressed by Morelli et al 42 who concludes that, in the absence of studies that define a standardized endometrial pattern after EA, transvaginal ultrasonography is of limited use in evaluating EA-treated women with postmenopausal bleeding. They recommend that women in whom the ultrasonogram indicates an echogenic or echolucent collection within the uterus undergo hysteroscopic evaluation.…”

Section: Discussionmentioning

confidence: 99%

Postablation Endometrial Carcinoma

Wortman

Vilos

et al. 2017

JSLS

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Background:Many women have undergone both resectoscopic and nonresectoscopic (or global) endometrial ablation (EA) during the past 20 years. These women are now approaching their sixth and seventh decades of life, a time frame in which endometrial carcinoma (EC) is most frequently diagnosed.Database:In several reports, surgeons have expressed concern that endometrial ablation may leave a sequestered island of EC that may escape detection, possibly delaying its diagnosis or causing it to appear at an advanced stage. Others suggest that EA artifact does not hinder the evaluation and treatment planning in the presence of EC. Data bases used are from Medline and PubMed.Discussion:We introduce 6 new cases of postablation endometrial carcinoma (PAEC), 4 of which occurred after the introduction of global endometrial ablation (GEA) techniques. In addition, we examine several key questions regarding the impact of EA on the subsequent development of EC, including the manner in which PAEC presents, the efficacy of traditional diagnostic modalities, the ablation-to-cancer interval, and the stage of PAEC at the time of diagnosis. Finally, we explore the use of reoperative hysteroscopic surgery (RHS) as a diagnostic modality and address the possible role ultrasound surveillance as a screening method for women at risk of EC.

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