الفهرس 
Endometrial ablationOnly 14 pages are availabe for public view
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Abstract
Objective: The aim of this study is to compare the different endometrial ablation techniques versus hysterectomy for the management of dysfunctional uterine bleeding. The study, which is a prospective randomized, will consider the operative time, operative and postoperative complications, short and long term outcomes, women satisfaction, overall costs of each procedure. Patients and Methods: This study, which is prospective randomized study, from May 2005, 99 patients with a complaint of dysfunctional uterine bleeding unresponsive to medical treatment, Patients were randomly assigned to endometrial ablation or hysterectomy (abdominal and vaginal) according to their order in admission to the hospital as follow; 39 patients to endometrial ablation [hysteroscopic endometrial resection (30 patient) and thermal balloon ablation (9 patients)], abdominal hystrectomy (30 patients) and vaginal hysterectomy on non prolapsed uterus (30 patients).At the end of each procedure we considered; Hospital stay, Postoperative hemoglobin, post operative complications (vaginal bleeding, pain , hematoma, fever, urinary tract infection),return of normal domestic activity, return to work, return of sexual activity, and patients quality of life and health related satisfaction. Results: In our study ,Shorter operative time in HER group (38 ± 6.1 minutes) and in TBA group (16.7 ± 2.5 minutes), than in AH group (76.2 ± 8.3 minutes) and in VH group (83 ± 17.5 minutes). Rapid resumption of normal domestic activity as it was in HER group after (6 ± 1.1 days) and in TBA group after (5.8 ± 0.4 days), than in AH group that was after (9.4 ± 1.7 days) and in VH group after (9.2 ± 2.6 days).Intra operative complications were more in the VH group, recurrence of abnormal bleeding was not significant as regard the HER group (3.3%) but was significant in the TBA group (33.3%). Development of pelvic pain was greater in the endometrial ablation group (TBA group 33.3% and the HER group 20%) than in the hysterectomy group (AH group 3.3% and VH group 3.3%).The cost of the procedure was significantly higher in TBA 833.3±39 L.E group than HER group 108.9 ± 7.4. L.E, AH group 231.4 ± 7.5 L.E and VH group 215.1 ± 7.6 L.E Patients satisfaction rate was significantly higher in hysterectomy group (AH group 96.7% and VH group 96.7%) than the endometrial ablation group (HER group 70% and TBA group 70%) Conclusion: Endometrial ablation in treatment of DUB have good short term prognosis that is comparable to hysterectomy , as regard the relief of symptoms, shorter operative time, short duration of postoperative pain and rapid recovery. The recurrence of abnormal bleeding is low with hysteroscopic endometrial ablation in contrary to thermal balloon ablation. Still, patients are satisfied more with hysterectomy than endometrial ablation.