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Photovaporization of the endometrium for menorrhagia: an alternative to hysterectomy

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Abstract

As an alternative to hysterectomy in patients with excessive bleeding, the endometrium was destroyed by means of the Nd:YAG laser. The photovaporization was done under direct vision through a hysteroscope. Fifty-five patients have been treated, all but one successfully, i.e., little or no menstrual flow. The human uterus having a thick myometrium was found to be ideal for this modality. To suppress endometrial regeneration further, each patient was placed on a regimen of danazol for 2-3 weeks prior to and after the procedure. Hysterograms after laser photovaporization showed variable degrees of uterine contraction, scarring, and adhesion formation. Biopsies of the endometrial surface up to 20 months following the procedure showed no evidence of inflammation other than foreign body giant ceil reaction around carbon particles. Minimal endometrical regeneration occurred.

© 1981 Optical Society of America

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