Curettage as endometrial pretreatment before microwave endometrial ablation:A clinical and experimental study / 中国微创外科杂志

ABSTRACT

Objective To investigate the value of thorough uterine curettage in microwave endometrial ablation(MEA).Methods Preoperative uterine curettage was conducted in 126 women with abnormal uterine bleeding(AUB)scheduled for MEA from June 2001 to June 2005.At the same period,another 12 patients with AUB underwent hysterectomy.And before the operation,uterine curettage and subsequent MEA were conducted.Then the uterine specimens were histopathologically and histochemically examined for evaluating the tissue damages.Results No intraoperative complications occurred in the 126 patients.Postoperatively,amenorrhea was observed in 78 patients(61.9%),normal menstruation was achieved in 46 patients(36.5%),and small amount of irregular vaginal bleeding was found in 2 patients(1.6%),the overall satisfaction rate being 98.4%(124/126).Postoperative complications included endometritis in 10 patients,hematometra in 2 patients,and dysmenorrhoea leading to hysterectomy in 2 patients.Follow-up observations were conducted for 6～28 months(22?4 months)in 126 patients,116 of whom were followed for more than 2 years.Follow-up findings showed satisfactory surgical effects.After MEA,the injury depth was 4.2～4.9 mm in the uterine fundus,4.1～5.7 mm in the anterior wall,4.7～6.6 mm in the posterior wall,and 4.0～4.7 mm in the uterine horn.Conclusions MEA with preoperative thorough uterine curettage can completely destruct the endometrium.The method offers good efficacy,high satisfactory rate,and low risk of tissue injury.