RANDOMIZED TRIAL COMPARING ROLLERBALL ABLATION WITH CUTTING LOOP ENDOMETRIAL RESECTION IN THE TREATMENT OF MENORRHAGIA

In order to compare the clinical efficacy, safety, success rate and probable complications of rollerball ablation with cutting loop endometrial resection in the treatment of menorrhagia, eighty-three women in reproductive age suffering from menorrhagia who did not respond to medication were treated in a randomized study comparing cutting loop endometrial resection with hysteroscopic rollerball ablation for treatment of menorrhagia between Sep. 1995-Aug. 1999 at Shiraz University of Medical Sciences' affiliated hospitals. After at least twelve months of follow up, results indicated that both techniques significantly reduced menstrual blood flow with no clinically significant difference between the two groups as reflected by return to normal bleeding or less (rollerball 95% and endometrial resection 93%). Rate of amenorrhea was 20.5% in rollerball and 25% in the resection group. Rate of post-op amenorrhea, hypomenorrhea and normal menses was almost similar in both series and the method of ablation had no influence on success rate. Only five patients (6%) were considered treatment failures, two from the rollerball and three patients from the resection group. Four of these required reoperation and one patient became amenorrheic after starting medication. None of the eighty-three patients experienced intra- or postoperative complications. Endometrial ablation by either rollerball or resection methods is therefore a successful, safe and cost-effective alternative for hysterectomy in the treatment of intractable menorrhagia.