Metody destrukcyjne w ambulatoryjnym leczeniu krwawień macicznych

Introduction of the ablation, in the 1980s, as a new technique of conservative management of metrorrhagiadue to endometrial hyperplasia has significantly decreased the percentage of hysterectomies and is gainingmore attention.Endometrial ablation with the use of hysteroscopy refers to three methods of endometrial removal, whichare defined as the first generation techniques. This group comprises transcervical endometrial resection, endometrialdestruction with the revolving electrode and the laser endometrial destruction.Based on our own hysteroscopic endometrial ablation material, which comprises 876 cases of hysteroscopicendometrial resection and 51 cases of endometrial destruction by the revolving electrode, our observations,experience and the efficacy of these procedures have been discussed.In the 1990s new methods using different types of energy for endometrial destruction, known as the secondgeneration techniques, were introduced. This group consists of thermal intracavitary balloons (ThermaChoiceSystem), hydro-thermic method (Hydrotherm System), multielectrode balloon system, microwave method, endometrialcryoablation and endometrial intrauterine laser therapy. These methods may be used provided thatendometrial atypia had been excluded and a regular follow-up is possible. The most common method of endometrialablation is one of the second generation techniques: ThermaChoice System.Although hysteroscopic endometrial resection is the most efficient method, the destructive methods areless invasive, easier to perform and involve fewer complications