Hysterectomy after endometrial ablation-resection

Study Objective. To evaluate the reasons for performing a hysterectomy in patients who had previously undergone endometrial ablation-resection (EA-R), after a follow-up of at least 6 years. Design. Retrospective study (Canadian Task Force classification II-3). Setting. University-affiliated hospital. Patients. Eighty-nine premenopausal women who underwent EA-R from February 1991 through February 2003. Interventions. Endometrial ablation-resection by electrocoagulation using a rollerball of the uterine fundus and tubal ostia zone, and electroresection using a cutting loop of the rest of the uterine cavity. Measurements and Main Results. During a minimum follow-up period of 6 years, hysterectomy was performed in 16 of 89 (77.97%) patients. In eight (9%) patients, hysterectomy was performed exclusively because of the failure of EA-R. The only factor that was related significantly to the increased possibility of requiring subsequent hysterectomy was the existence of myomas. Conclusion. After long-term follow-up (more than 5 years), approximately one out of every five women who undergo EA-R will require a hysterectomy. The majority of these will be required during the first 2 years following EA-R. The existence of uterine myomas at the time of EA-R can be considered a risk factor for the subsequent need for hysterectomy.