The role of pathologic evaluation of endometrial ablation resections in predicting ablation failure and adenomyosis in hysterectomy

摘要: Endometrial ablation is commonly performed to manage heavy menstrual bleeding. However, failure in symptom control eventually requiring hysterectomy frequent. Adenomyosis common such cases. Ablations using a resectoscope will produce an Endo-Myometrial Resection (EMR) specimen. The value of histopathologic examination EMRs predicting treatment and adenomyosis has not been addressed. We retrieved histologic material from subjects with failed (persistent symptoms hysterectomy) followed by clinical improvement no (control group). Material was evaluated for features abnormal endometrial distribution suggestive adenomyosis: myometrial fragments endometrium on opposite edges, myometrium ≥3 edges areas completely surrounded (endometrial islands). Hysterectomy specimens the study group were presence its (superficial/deep). Both groups consisted 18 patients each. number sides significantly higher group: 2.11 vs 0.94 (p=0.005). Conversely, maximum aggregate dimension (2.3cm 2.79cm), three (4.5 2.78) islands 4.11) did differ between groups. seen 72.2% hysterectomies group; 27.8% involved deep myometrium. None EMR statistically associated adenomyosis. Certain endomyometrial patterns correlate future need definitive surgery. This may be explained residual tissue resected due markedly irregular interface. frequent cases failure. significant association studied observed.