Ultrasound Uterine Evaluation: Pre and Post Endometrial Ablation in Cases of Refractory Uterine Bleeding

Document Type : Original Article

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obstetrics and Gynecology, Zagazig University, Zagazig, Egypt

Abstract

Background: Endometrial ablation is an alternative minimal invasive method to avoid invasive surgery such as hysterectomy.
Aim of the Work: This Prospective study aimed Pre and post endometrial ablation ultrasound evaluation after endometrial ablation. 50 cases complained of bleeding not responding to medical treatment with no pathological or structural causes were selected for the procedure.
Methods: D&C was done, followed by insertion of Foley`s catheter into uterine cavity, 30cc of boiled saline were used to inflate its ballon, temperature was maintained by frequently changing saline by another boiling one. Patients were instructed to come for follow up at 3 and 8 months after procedure. Pre and post endometrial ablation Ultrasound evaluation was done.
Results: (70%) of patients had clinical improvement, whereas (30%) Still have persistent uterine bleeding following ablation. Hypomenorrhea was the most frequent menstural pattern (34%) , on other had amenorrhea occurred in 20% of cases. There were significant increases of uterine artery RI in all cases at 3 and 8 months follow up except in patients with eumenorrhea and those with persistent bleeding.
Conclusion: Significant reduction of endometrial thickness was reported in all patients except in those with Eumenorrhea and persistent post ablation menorrhagia. A significant reduction in uterine volume was reported after 3 and 8 months in cases with post operative amenorrhea and hypomenorrhea. There were significant increases of uterine artery pulsitility index in all cases except 3 month post-operatively in patients with eumenorrhea and those with persistent menorrhagia where the changes were not significant.

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