Six hundred endometrial laser ablations.

Abstract

To report the effectiveness and safety of endometrial laser ablation in the treatment of menorrhagia, as determined by detailed follow-up of 600 operations for at least 6 months. Operative data from 600 endometrial laser ablations performed on 524 women were collected. Five hundred one (96%) of these women were followed with consultations and questionnaires. The mean duration of follow-up was 15 months (range 6-42). No major operative morbidity occurred. There were no cases of primary or secondary hemorrhage, uterine perforations with the operating instrument, or immediate laparotomy. A successful outcome was reported by 83.4% of patients. A second endometrial laser ablation was required in 14.3% of the women. Success increased with increasing age and low fluid absorption. Cavity length, operation time, duration of follow-up, and whether it was a first or second procedure were not associated with any difference in the success rate, although the hysterectomy rate tended to rise with increasing length of follow-up. This study, the largest one published from a single institution, with a mean follow-up duration of 15 months, confirms that endometrial laser ablation is a safe and effective treatment for dysfunctional uterine bleeding.