Successful microwave endometrial ablation (MEA) in uterus didelphys.

摘要

A 44-year-old woman was referred to the Menstrual Ablation Clinic (MAC) with a 2 year history of therapy resistant menor-rhagia. Menstruation lasted for 1 week, with clotting and flooding during the menstrual flow. She required double sanitary protection, changing half-hourly for 3 of the 7 days. She also had severe dysmenorrhoea. Her menstrual score was 16 (Sharp et al. 1995). She was parous with one previous normal delivery.Of note in her gynaecological history was excision of a vaginal septum and known uterine anomaly. Assessment with vaginal ultrasound confirmed the presence of uterus didelphys with duplication of uterine and cervical canals, but no other pathology was found. Speculum examination revealed aparous cervix, but only one os was easily identified. Endometrial biopsy was performed.Various options were discussed and the patient selected Microwave Endometrial Ablation (MEA) as her preferred treatment.Because of the uterine anomaly, full hysteroscopic control under general anaesthesia was considered essential. Endometrial preparation was achieved with Goserelin (Zoladex, AstraZeneca, Macclesfield, Cheshire, UK) 3.6 mg subcutaneously administered 5 weeks before admission.