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Ultrasound-guided reoperative hysteroscopy for managing global endometrial ablation failures.

STUDY OBJECTIVE: To determine whether ultrasound-guided reoperative hysteroscopy can reduce the need for hysterectomy in women experiencing delayed complications after global endometrial ablation (GEA) procedures.

DESIGN: Retrospective review (Canadian Task Force classification III).

SETTING: Private physician's office.

PATIENTS: Fifty women who had experienced a delayed complication after a GEA procedure were referred to the author's private practice.

INTERVENTION: All 50 women underwent ultrasound-guided reoperative hysteroscopy in which the uterine cavity was fully explored and areas of endometrial growth and other disease were identified and excised.

MEASUREMENTS AND MAIN RESULTS: Intraoperative complications, patient satisfaction, and avoidance of hysterectomy were determined. There were no intraoperative or postoperative complications. The mean duration of follow-up was 18.1 months (95% confidence interval, 13.8-22.4). Forty-four of 49 patients (88.9%) were satisfied with the outcome, and further surgery was not necessary during the study period.

CONCLUSION: Ultrasound-guided reoperative hysteroscopy is a safe and effective minimally invasive treatment for management of delayed complications after GEA procedures.

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