Die hysteroskopische Endometriumablation--vom experimentellen Ansatz zu einer etablierten Methode.

ABSTRACT

A total of 94 pre- or peri-menopausal patients from eight centres with intractable uterine bleedings and completed family planning were assessed as part of a clinical trial on the use of leuprorelin acetate monthly depot prior to endometrial ablation. The primary target criterion was flattening of the endometrium after two injections of 3.75 mg leuprorelin acetate depot with an interval of one month between injections. Endometrial thickness before the first injection was compared with the thickness prior to surgery (two weeks after the second injection). Mean endometrial flattening of 4.0 +/- 4.1 mm was found. Sufficient pretreatment was achieved in 91.3% of the patients with > 50% decrease. In terms of clinical response, the development of amenorrhoea, hypomenorrhoea or normal menstruation was assessed six weeks and still 83% after six months. In view of the good study results, hormone-suppressive pretreatment can be recommended prior to hysteroscopic endometrial ablation. Surgery should then take place about two weeks after the second injection.