Focal Treatment of Uterine Bleeding and Infertility with Nd:YAG Laser and Flexible Hysteroscope

ABSTRACT

This long-term study involves 160 patients, referred for hysterectomy, who complained of uterine bleeding that was resistant to conventional treatment. Before surgery, these patients had a diagnostic hysteroscopy that showed that the bleeding was caused by submucosal fibroids, intrauterine or cervical polyps either alone or in association with adenomyosis, or adenomyosis alone. These patients were treated as outpatients with the Nd:YAG laser, under paracervical anesthesia. In 75.5%, the menstrual cycle returned to normal after one treatment, and in 5.5% was normal following repeat surgery. Eight patients required hysterectomy because hysteroscopy was impossible owing to the multiple fibroids or psychologic reasons. Nine patients have been lost to follow-up observations. (J GYNECOL SURG 5:177, 1989)