Hysteroscopic Endometrial Ablation as a Treatment of Abnormal Uterine Bleeding in Renal Transplant Patients.
- Author:
Da Jung CHUNG
1
;
Ki Hyun PARK
;
Kyung Ah JEONG
;
Jong Seung SHIN
;
Sang Wook BAI
;
Byung Seok LEE
;
Dong Jae CHO
;
Chan Ho SONG
Author Information
1. Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Abnormal uterine bleeding;
Renal transplant;
Hysteroscopic endometrial ablation
- MeSH:
Academic Medical Centers;
Amenorrhea;
Endometrial Ablation Techniques*;
Estradiol;
Female;
Follicle Stimulating Hormone;
Follow-Up Studies;
Gynecology;
Hemorrhage;
Humans;
Hysterectomy;
Kidney Transplantation;
Metrorrhagia;
Obstetrics;
Prolactin;
Reference Values;
Retrospective Studies;
Thyrotropin;
Uterine Hemorrhage*
- From:Korean Journal of Obstetrics and Gynecology
2003;46(6):1135-1139
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To assess the effectiveness and safety of hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding developed in renal transplant patients. METHODS: Data were collected retrospectively from 62 patients referred to Department of Obstetrics and Gynecology, Yonsei University Medical Center from January 1999 to December 2001 for abnormal uterine bleeding with prior history of renal transplantation who subsequently received hysteroscopic endometrial ablation. Hormonal status of these patients were evaluated before the operation by sampling estradiol (E2), lutenizing hormone (LH), follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), and prolactin. Mean follow-up duration was 6 months. Levonorgestrel-releasing intrauterine system (LNG-IUS)s were inserted in those who experienced recurrent bleeding. RESULTS: Mean age of patients was 34.6+/-6.7 years and mean duration from renal transplant to onset of abnormal uterine bleeding was 4.5+/-2.5 years. All hormone levels (E2, LH, FSH, TSH, prolactin) were within normal range. 54 out of 62 patients (87.0%) who underwent hysteroscopic endometrial ablation reported decreased bleeding: amenorrhea in 25 (40.3%), spotting in 19 (30.6%), and eumenorrhea in 10 (16.1%). None reported complications related to the procedure. LNG-IUSs were inserted into 8 patients who experienced continuous bleeding, 5 out of whom showed symptomatic improvement: spotting in 3 (4.9%) and eumenorrhea in 2 (3.2%). 3 patients in whom LNG-IUS had no effect received total abdominal hysterectomy. CONCLUSION: Hysteroscopic endometrial ablation as a surgical management of abnormal uterine bleeding developed in renal transplant patients is an effective and safe procedure.