Features of the post-operating period after the endometrial ablation in post-menopausal aged women with hyperplastic processes of endometrium

Abstract

The paper presents the results of surgical treatment of 45 postmenopausal women with non-atypical forms of endometrial hyperplasia. The objective: is to establish the features of the postoperative period depending on the method of endometrial ablation in postmenopausal patients with endometrial hyperplastic processes. Materials and methods. The study included 45 women with non-atypical forms of endometrial hyperplasia: 25 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who were treated with hysteroscopic monopolar ablation of the endometrium and 20 women of postmenopausal age with non-atypical forms of endometrial hyperplasia, who underwent radiowave endometrial ablation. In the postoperative period, on 3, 7 days and after 1, 3, 6, 12, 24 months, the complaints, the general condition, the nature of the discharge from the genital tract were evaluated, gynecological examination with ultrasound examination of the pelvis were provided, office hysteroscopy or endometrial aspiration from the uterus were provided according to indications. Results. It is advisable to recommend endometrial ablation for the patients with non-atypical forms of postmenopausal endometrial hyperplasia as an alternative to hormonal treatment or hysterectomy. The efficiency of radiowave ablation of the endometrium with non-atypical forms of endometrial hyperplasia is 85.0%. The effectiveness of monopolar hysteroscopic ablation of the endometrium in women with non-atypical forms of endometrial hyperplasia is 96.0%. In the case of recurrence of the endometrial hyperplastic process (bleeding, thickening of the M-echo according to ultrasound data), hysteroscopy is shown with mandatory hystopathological studies and diagnosis verification. Conclusions. After ablation of the endometrium, follow-up is advisable for two years. The method of choice for follow-up observation of the state of the endometrium of the uterus in women after endometrial ablation is transvaginal ultrasound, which is performed after 1, 3, 6, 12 and 24 months of observation. Key words: endometrial hyperplastic processes, postmenopausal women, endometrial ablation.