Ultrasound-Guided Reoperative Hysteroscopy for Managing Global Endometrial Ablation Failures

Abstract

Study ObjectiveTo determine whether ultrasound-guided reoperative hysteroscopy can reduce the need for hysterectomy in women experiencing delayed complications after global endometrial ablation (GEA) procedures. DesignRetrospective review (Canadian Task Force classification III). SettingPrivate physician's office. PatientsFifty women who had experienced a delayed complication after a GEA procedure were referred to the author's private practice. InterventionAll 50 women underwent ultrasound-guided reoperative hysteroscopy in which the uterine cavity was fully explored and areas of endometrial growth and other disease were identified and excised. Measurements and Main ResultsIntraoperative complications, patient satisfaction, and avoidance of hysterectomy were determined. There were no intraoperative or postoperative complications. The mean duration of follow-up was 18.1 months (95% confidence interval, 13.8–22.4). Forty-four of 49 patients (88.9%) were satisfied with the outcome, and further surgery was not necessary during the study period. ConclusionUltrasound-guided reoperative hysteroscopy is a safe and effective minimally invasive treatment for management of delayed complications after GEA procedures.