Treatment of dysfunctional bleeding and fibroids by advanced endoscopic techniques with the Nd:YAG laser: from the present to the future.

Donnez, Jacques;Polet, R.;Anaf, V.;Mathieu, Paul;Nisolle, M.;et.al.
(1995) Baillière’s Clinical Obstetrics and Gynaecology — Vol. 9, n° 2, p. 329-345 (1995)

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  • Donnez, JacquesUCLouvain
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  • Polet, R.
    Author
  • Anaf, V.
    Author
  • Mathieu, PaulUCLouvain
    Author
  • Nisolle, M.
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Abstract
Both the electrical current of the resectoscope and the energy of the Nd:YAG laser have been effective tools in the destruction of endometrial tissue to a sufficient depth to avoid regeneration. GnRH-agonist therapy effects a decrease in the total uterine cavity area which facilitates surgical treatment and reduces the risk of fluid overload syndrome. The recurrence rate of meno/metrorrhagia is higher when the uterine cavity is more than 10 cm2. The use of GnRH-agonists represents an adjunct for preoperative reduction of submucosal myomas so that subsequent hysteroscopic myomectomy is possible. A two-step hysteroscopic therapy combined with GnRH-agonist therapy is performed when the largest portion of the submucosal myoma is located in the uterine wall. In cases of numerous submucosal and intramural myomas, a laparoscopic supracervical hysterectomy is performed because of the high risk of recurrence after the hysteroscopic procedure.
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Donnez, J., Polet, R., Anaf, V., Mathieu, P., Casanas-Roux, F., & Nisolle, M. (1995). Treatment of dysfunctional bleeding and fibroids by advanced endoscopic techniques with the Nd:YAG laser: from the present to the future. Baillière’s Clinical Obstetrics and Gynaecology, 9(2), 329-345. https://hdl.handle.net/2078.5/132378 (Original work published 1995)