Electrocoagulation of the endometrium. A new method for the treatment of hemorrhagic disorders in women

The purpose of this investigation was to evaluate endometrial ablation as an alternative treatment for heavy dysfunctional menstrual bleeding in women with indications for hysterectomy. After preliminary treatment with danazol 200 mg q.i.d. for four weeks, transcervical endometrial ablation was performed in general anaesthesia with a hysteroresectoscope and the "rollerball" electrode. Twenty-five consecutive patients were treated and discharged the following day. Twenty-two patients (88%) were very satisfied with the result. 68% became hypomenorrhoeic and 20% amenorrhoeic. Three patients required a hysterectomy because of continuing bleeding due to intrauterine septum and fibroma. The median follow-up time was seven months. Eight patients (32%) had either a submucus fibroid or an intrauterine septum. Neither uterine perforations nor major complications occurred. Endometrial ablation with the "rollerball" method appears to be an easy, cost-effective, safe and efficient treatment for heavy severe menorrhagia.