Hysteroscopic endometrial ablation as a treatment for abnormal uterine bleeding in patients with renal transplants.

Study Objective: To assess the effectiveness and safety of hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding that develops in patients with renal transplants.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Yonsei University Medical College, Severance Hospital.

Patients: Sixty-two women with abnormal uterine bleeding who had undergone renal transplantation.

Intervention: Hysteroscopic endometrial ablation.

Measurements And Main Results: Fifty-four out of 62 patients (87.0%) who had undergone hysteroscopic endometrial ablation reported decreased bleeding (95% CI: 0.76 to 0.94): amenorrhea in 25 (40.3%), spotting in 19 (30.6%), and eumenorrhea in 10 (16.1%). Mean follow-up duration was 6 months. No complications related to the procedure were reported. Levonorgestrel-releasing intrauterine systems (LNG-IUSs) were inserted into eight patients who experienced continuous bleeding, five of whom showed symptomatic improvement: spotting in three (4.9%) and eumenorrhea in two (3.2%). The three patients (4.9%) in whom the LNG-IUS had no effect had hysterectomies, and the resultant pathologic findings were two cases of adenomyosis and one case of simple endometrial hyperplasia without atypia.

Conclusion: Hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding that develops in patients with renal transplants is an effective and safe procedure.