A comparison of endometrial ablation using the Nd:YAG laser or electrosurgical techniques.

Study Objective: To compare the results of endometrial ablations performed either with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser or electrosurgically.

Study Design: Retrospective study, with 4-year follow-up of 82 of 98 patients.

Setting: Gynecology departments of teaching, community, and proprietary hospitals.

Patients: One hundred sixty-six women requiring surgical treatment for menorrhagia between March 1986 and October 1992.

Interventions: Fifty-eight women were treated with a Nd:YAG laser, 11 with a rollerball electrode, and 97 with a wire loop electrode. Concomitant resection of submucous leiomyomata was performed in 54 (32.5%) of the patients.

Measurements And Main Results: The mean operating times, complication rates, mean volume of fluid absorption, concomitant surgery, morbidity, duration of hospital stay, and results of laser and electrosurgical endometrial ablations were similar. Thirty-nine women (69.9%) undergoing laser endometrial ablation became amenorrheic and 54 (96.4%) had satisfactory results after 6 months. Seven (63.3%) of the women who had a rollerball ablation became amenorrheic, and 10 (90.9%) had satisfactory results. Sixty-one women (70.9%) who underwent wire loop resection became amenorrheic, with 83 (96.5%) attaining satisfactory results. Four years postoperatively, 85.4% of the patients continued to have satisfactory results.

Conclusions: Laser and electrosurgical endometrial ablations are similarly effective treatment for patients suffering from chronic menorrhagia. This preliminary study should be followed by a randomized, controlled, prospective study to evaluate the two techniques more fully.