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Guideline source: American College of Obstetricians and Gynecologists
Literature search described? Yes
Evidence rating system used? Yes
Published source: Obstetrics & Gynecology, May 2007
Available at: http://www.greenjournal.org/cgi/ reprint/109/5/1233 (subscription required)
Endometrial ablation refers to minimally invasive surgical procedures that treat abnormal uterine bleeding in select women who have no desire for fertility. In its guidelines for endometrial ablation, the American College of Obstetricians and Gynecologists (ACOG) compare standard resectoscopic endometrial ablation with nonresectoscopic endometrial ablation techniques and devices. ACOG also reviewed the indications, effectiveness, safety, and limitations of endometrial ablation.
Indications
Endometrial ablation should be used to treat premenopausal women with normal endometrial cavities who have menorrhagia or patient-perceived heavy menstrual bleeding. These should be women who have no desire for future fertility, and they most likely will have been unsuccessful with or are intolerant of medical therapy. Although failure or intolerance of medical therapy and anemia are important considerations, they are not prerequisites for the procedure.
When excessive bleeding or menorrhagia occurs in the context of submucosal myomata, endometrial ablation may be effective. However, this depends on the diameter and...