engleski

The role of diagnostic hysteroscopy proir the thermal balloon ablation of endometrium (thermachioce) in treatment of recurrent menopausal metrorrhagia

Between November 2002 and March 2004 in Department of Gynecology and Obstetrics of Požega County General Hospital we treated totally 18 women with recurrent menopausal metrorrhagia by the method of thermal balloon ablation (TBA) of endometrium vvith Thermachoice (Gynecare, Johnson & Johnson) using Ali of those patients vvere in menopausal age, 7 (38, 9%) of them vvere older than 50 (average age 48, 2 ; range 38-55) Ali of them vvere bad responders on standard therapy of menopausal metrorrhagia, i.e. dilatation and curettage (D&C), oral or/and parenteral uterotonics, hormonal replacement therapy (HRT) etc. Ali patients vvere underwentto bimanual pelvic examination, colposcopy, Pap-test, microbiological cervical smear and transvaginal color-doppler ultrasound. In ali patients we performed diagnostic histeroscopy (Richard Wolf GmbH) for visual assessment and target endometrial sampling and histological verification prior to TBA. Ali histological findings shovved benignant endometrial changes in range of functional thickness to simple hyperplasia. In comparison to explorative D&C, diagnostic histeroscopy shovved much more advantages ; dilatation of cervical channel vvas unnecessary, endometrial biopsy vvas visually guided, procedure was simple, painless and vvithout general anesthesia, as well as brief hospitalization and recovery. TBA also shovved a lot of advantages as alternative of hysterectomy in cases of benignant endometrial changes, i.e. no need for cervical dilatation and general anesthesia, brief duration of procedure (8 minutes on temperature o£87-186°C and fluid pressure in balloon of 160-180 mmHg) and short postoperative hospitalization. Namely, patients can go home 2 hours after the treatment, vvhich is really one- day surgery . Both procedures have a short learning-curve and they are verv appropriate for outpatients treatment.

recurrent menopausal metrorrhagia ; thermal balloon ablation (TBA)

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