Photodynamic Ablation of the Endometrium With the Nd:YAG Laser Hysteroscopically as a Treatment of Menorrhagia

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Abstract
Hysteroscopic Nd:YAG laser photocoagulation was performed on 18 patients with chronic menorrhagia to hopefully decrease the menstrual flow sufficiently to avoid hysterectomy or to produce permanent amenorrhea. The endometrial lining was treated from each tubal ostia down to 2 cm from the external cervical os. This was accomplished by holding the laser fiber tip 2 to 4 mm from the endometrial surface under hysteroscopic control and activating the laser until blanching occurred. AH the patients were carefully followed for a minimum of three months. All but four noted a marked reduction in the amount of menstrual flow and one has become totally amenorrheic, while seven have only slight spotting. There were no operative complications and all patients have been able to avoid subsequent hysterectomy or other therapy to date.