A randomized comparison of endometrial laser intrauterine thermotherapy and hysteroscopic endometrial resection

Objective: To investigate the difference of long-term amenorrhea rate in patients with menorrhagia treated by endometrial laser intrauterine thermal therapy (ELITT), a new nonhysteroscopic endometrial ablation proce- dure, versus transcervical hysteroscopic endometrial resection (TCRE). Design: Randomized clinical study. Healthy volunteers in an academic research environment. Setting: Academic teaching hospital. Patient(s): Premenopausal women with abnormal uterine bleeding. Intervention(s): Fifty-eight patients were treated with the ELITT procedure and 58 patients with TCRE; both groups were treated with GnRH agonists before the procedure. Main Outcome Measure(s): Bleeding status and patient satisfaction after treatment were evaluated as well as the intraoperative complication rate. Result(s): At 12 months, the amenorrhea rate was 56% in the ELITT group and 23% in the TCRE group. At 36 months, the figures were 61% for ELITT and 24% for TCRE. No significant complications were recorded for either procedure. Conclusion(s): Results of this randomized study demonstrate that both procedures are equally effective in the treatment of menorrhagia. However, the ELITT procedure has proven to be superior in inducing amenorrhea.