Cryosurgery Is a Simple Modality for Endometrial Ablation

Abstract

This study assessed whether destruction of the uterine endometrial lining using a CMS Accuprobe effectively treats abnormal uterine bleeding. Two postmenopausal and seven premenopausal women with endometrial biopsies consistent with hyperplasia with or without atypia were considered high medical risks for surgery. They refused hysterectomy or failed conventional medical therapy, and thus were offered endometrial ablation using a cryoprobe maintained at -176° C. Preoperative and postoperative magnetic resonance imaging (MRI) examinations were performed in five women. All patients had intraoperative hysteroscopy and dilatation and curettage. Postoperative hysteroscopy and endometrial biopsies were performed in two. General anesthesia was used in three patients and intravenous sedation with cervical blocks in six. Five women were ablated while receiving full anticoagulation for cardiac conditions. All patients had a postoperative serosanguineous discharge up to 6 weeks and remained amenorrheic, with two exceptions both reporting normal menses beginning 2 to 3 months after ablation. Postoperative MRI revealed a decreased endometrial stripe with globular edema in the fundus. Postablative hysteroscopy was consistent with fibrous tissue, and endometrial sampling revealed granulation tissue. Preliminary results suggest that endometrial cryoablation appears to be well tolerated. Further investigation is warranted to determine its future role.