Diagnostic hysteroscopy to evaluate the cause of abnormal uterine bleeding.

Diagnostic hysteroscopy has become an important and valuable tool for the gynecologist in the evaluation of many conditions previously evaluated with blind and inaccurate techniques. The safety, ease of proficiency, and ability to see and diagnose in an office setting have taken much of the guesswork out of office diagnosis. This modality brings the evaluation of many pathologic conditions, including the cause for abnormal uterine bleeding, infertility, and recurrent pregnancy loss, back into a relaxed office environment.

Effects of vasopressin administration during hysteroscopic surgery.

A study was performed to assess the effect of dilute vasopressin on intraoperative bleeding and intravasation of the medium during resectoscopic hysteroscopic surgery. Dilute vasopressin or placebo was injected into the cervical stroma at the commencement of resectoscopic endometrial ablation and/or submucous myomectomy in a prospective, computer-generated, double-blind, placebo study. The operator estimated the intraoperative bleeding.

What's new in gynecologic endoscopy: endometrial ablation.

From January 1987 to December 1993, 247 patients underwent endometrial ablation as an alternative to hysterectomy in our practice. All these patients had abnormal uterine bleeding, and were evaluated by diagnostic office hysteroscopy and endometrial biopsy and then treated in the hospital outpatient center. The success rates for the procedure were greater than 95% as measured by patient satisfaction, and had amenorrhea rates varying from 50% for those patients in their reproductive years to 85% for those patients who were postmenopausal.

Endometrial ablation in women with abnormal uterine bleeding aged fifty and over.

Endometrial ablation, rapidly becoming a standard operation for the management of abnormal uterine bleeding, is usually performed for patients between ages 35 and 45. This study reports on the results of resectoscopic endometrial ablation for 26 patients aged 50 and older, followed from 7 to 43 months (average follow-up period, 21 months). Seventeen of the patients were menopausal at the time of the procedure or became menopausal during the follow-up period, with 13 on combined estrogen and progestin therapy and 4 on unopposed estrogen (because of progestin intolerance).

Preoperative therapy in preparation for endometrial ablation.

In order to improve the success of endometrial ablation for uncontrolled uterine bleeding, a variety of preoperative agents were utilized. Patients were given either no preparation, progestins, danazol or leuprolide acetate depot as preoperative therapy to determine the best way to increase the incidence of amenorrhea and to decrease the failure rates. The lowest rates were achieved with danazol or no preparation, with amenorrhea rates of 41 and 43%, respectively.