Akademik

the removal of the entire endometrium by means of an ablative technique, usually under hysteroscopic control and usually performed as a day case. It is an alternative to the more traditional hysterectomies that were undertaken for the relief of menorrhagia. Methods for hysteroscopic endometrial ablation introduced in the 1980s included Nd:YAG (neodymium:yttrium-aluminium-garnet) laser ablation, transcervical resection of the endometrium (TCRE), and rollerball electrocoagulation (RBE). These first-generation procedures remain the gold standard for the hysteroscopic treatment of menorrhagia. In the 1990s, the second generation of hysteroscopic ablation techniques were developed, including balloon heating methods (Thermachoice), in which a balloon filled with a hot liquid is inserted into the uterus and causes the endometrium to slough off; microwave endometrial ablation (MEA); a radio-frequency method (Menostat); and a cryotherapy method. They all seem to be equally effective in achieving their aim.