ACOG Guidelines on Endometrial Ablation

摘要

The following recommendations are based on limited or inconsistent scientific evidence: * Hysterectomy rates associated with resectoscopic and nonresectoscopic endometrial ablation are 24 percent or more within four years after the procedure. * Women with previous or concomitant laparoscopic sterilization who undergo endometrial ablation are at low risk of developing intermittent or cyclic pelvic pain after the procedure. * Women with normal endometrial cavities have similar patient satisfaction and reduction in menstrual blood flow after endometrial ablation as women who use the levonorgestrel-releasing intrauterine system (Mirena). The following recommendations are based primarily on consensus and expert opinion: * Physicians should advise patients who choose endometrial ablation that normalization of menstrual blood flow may be the outcome of the procedure. * Physicians should counsel premenopausal patients undergoing endometrial ablation to use appropriate contraception. * Nonresectoscopic endometrial ablation is not recommended in women who have endometrial cavities that exceed device limitations. * Physicians should test the endometrium of all candidates for endometrial ablation.