الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
For many women, excessive menstrual bleeding is physically incapacitating, financially draining and socially embarassing. Unfortunately the problem is not rare and it is estimated that menorrhagia occurs up to 20% of women especially at the late part of their reproductive life. The excessive uterine bleeding may be due to some organic causes such as benign, malignant or pregnancy related canditions, but in many cases the problem is due to abnormality of the hypothalamic-pituitary ovarian axis what we called dysfunctional utrine bleeding (DUB) The treatment of patients complaining of DUB mostly medical and hormonal but some of them do not responsd to those therapy. Hystrectomy was the ideal treatment and the final approach. In the recent years, depending on the events of Asheman’s syndrome, many gynaecologists tried to induce Ashennan like condition in the endometrial cavity as a method for controlling of the menstrual abnormality. With the advances in the hysteroscopic techniques, there had been increasing enthusiasm for the treatment of menstrual disorders by endoscopic destruction of the endometrium. i.e. endometrial ablation. ( 3utmuzr-q and Conclusion ) Long term outcomes of the procedure had pointed out. Special attension was payed to the various factors affecting the success rate of the procedure One of the most important factor that affect the outcome of the procedure is the endometrial thickness. Many investigators had been tried various methods to achive a thin endometruim prior to the time of ablation, one of these metods is the hormonal inhibition of the endometiurn using GnRH analogues, progestogens, ..etc. Another method is the mechanical removal of the thick endometrium by the mean of curettage. In the present study we were aiming to evaluates the effect of various methods of preoperative protocols of endometrial preparation on the operative procedure and the postoperative results of surgery. All of our patient had a perimenopausal DUB, completed their families and no suspicious of malignancy or pregnancy. All of our patient had been treated with Hysteroscopic electroablation. The patient was classified into 4 groups according to the protocols of preoperative endometrial preparation: group I:- Had no preoperative preparation and the procedure of ablation was attempted just postmenstrually. group 11: Had treated firstly by a dilatation and curettage operation one week latter the procedure of electroablation was done . group 111: Had treated by GnRH analogue Triptorelin (Decapeptyl 3.75mg IM) then eletroablation was done 4 week later. group IV: Had treated by progestagen compounds, medroqprogesteron acetate (proveraTM 5mg twice daily) for at least 6 weeks but not more than 9 weeks after which electroablation was done. All of the preoperative, intraoperative and post operative data were collected tablated and statisitically analysied. The effect of preoperative medication with GnRH analogne was dramatically superior to the other protocol of preparation regarding to preoperative thining of the endometrium, diminution of uterine length, diminution of endometrial vascularily, short operative time and excellent postoperative outcome. Six months latter amenorrheic rate among this group receving GnRH analogue was promising and the degree of satisfaction was so high vresus other study group. Patients who had dilatation and curettage preoperative preparation showing an intermediate results as regard to intraoperative and postoprative outcomes. While the other 2 groups, one was prepared by progestagens and the other group was just postmenstrual, were showing the poorest result in our study.