Successful AEGEA Vapor-Based Endometrial Ablation: An In Vivo. Peri-Hysterectomy Study. Garza-Leal J,1 Hernandez I,1 Castillo L,1 Chill N,2 Coad JE.2.
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Abstracts / Journal of Minimally Invasive Gynecology 17 (2010) S109–S127
maintenance of cavity patency after primary treatment of intrauterine adhesions.
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Open Communications 25dHysteroscopy II (9:36 AM d 9:41 AM)
Levonorgestrel-Releasing Intrauterine System Compared to Low Dose Combined Oral Contraceptive Pills for Idiopathic Menorrhagia: A Randomized Clinical Trial Sayed GH,1 El-Nashar SA,1,2 Zakhera MS,1 Shabaan MM.1 1Obstetrics and Gynecology, Women Health Center, Assiut, Egypt; 2Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
Using alkaline hematin, the reduction in MBL was significantly more in the LNG-IUS group (87.411.3%) compared to the COC group (34.976.9%) (P =0.013). Utilizing PBLAC scores, the reduction in the LNG-IUS (86.617.0%) group was significantly more compared to the COC group (2.593.2%) (P \0.001) In the LNG-IUS group, increase in the hemoglobin and ferritin levels were noted (from 10.21.3 to 11.41.0 g/dL; P \0.001; with reduction of the number of lost days (from 6.82.6 to 1.62.4 days, P =0.003).
Study Objective: This study compared the efficacy of the levonorgestrelreleasing intrauterine system (LNG-IUS) to low dose combined oral contraceptive pills (COC) in the management of idiopathic menorrhagia. Design: A single center, open, randomized clinical trial. Setting: An Academic Insitution in Egypt. Patients: One hundred-twelve women complaining of excessive menstruation who desired contraception were included in the study. Intervention: Participating women were randomized to receive LNG-IUS or COC. Treatment failure was defined as the need for medical or surgical treatment during the follow-up. Other outcomes included: menstrual blood loss (MBL) by alkaline hematin and by pictorial blood assessment chart (PBLAC); hemoglobin levels; and assessment of lost days in which physical or mental health prevented participating women from performing usual activities. Measurements and Main Results: At baseline, LNG-IUS and COC groups were comparable in age, parity and MBL. Table 1 Baseline characteristics of the study population
Age, years Parity BMI, kg/m2 Dysmenohrea Completed 12 m of follow up
LNG-IUS group (n=56)
COC group (n=56)
P value
39.36.7 3 (range1,6) 29.65.9 9 (16.1%) 48 (85.7%)
38.75.2 3 (2,6) 31.15.7 13 (23.2%) 47 (83.9%)
0.637 0.802 0.175 0.476 0.792
LNG-IUS, levonorgestrel intrauterine system; COC, combined oral contraceptive; BMI, body mass index Time to treatment failure was longer in LNG compared to COC group with a total of 6 (11%) patients who had treatment failure in the LNG-IUS compared to 18 (32%) in COC group with a hazard ratio of 0.30 (95%CI, 0.15-0.73, P =0.007).
Conclusion: The LNG-IUS is a more effective therapy for idiopathic menorrhagia compared to COC.
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Open Communications 25dHysteroscopy II (9:42 AM d 9:47 AM)
Successful AEGEA Vapor-Based Endometrial Ablation: An In Vivo Peri-Hysterectomy Study Garza-Leal J,1 Hernandez I,1 Castillo L,1 Chill N,2 Coad JE.2 1 Department of Gynecology, Universidad Auto´noma de Nuevo Leo´n Facultad de Medicina, Monterrey, NL, Mexico; 2Pathology Laboratory for Translational Medicine, West Virginia University, Morgantown, West Virginia Study Objective: To evaluate the vapor-based AEGEA Endometrial Ablation System using an in vivo peri-hysterectomy model. This study evaluated: 1) the primary intrauterine cavity thermal ablation characteristics and 2) the ablation’s relationships to the uterine serosa, fallopian tubes and endocervical canal. Design: Single site feasibility study. Setting: University medical center. Patients: Nine women consented for AEGEA endometrial ablation prior to undergoing a previously scheduled hysterectomy for abnormal uterine bleeding. Intervention: In vivo AEGEA endometrial ablation was performed using a 90 second vapor treatment cycle. Following hysterectomy, the uteri were examined for the extent/location of endomyometrial ablation (macroscopic TTC staining) and fallopian tube injury (microscopic NBT staining). Measurements and Main Results: The 9 uteri weighted 143 40g and measured 10.3 1.3cm in length, 4.4 0.6cm in thickness and 6.2 0.7cm in width. The endometrial thickness was 1.1 0.7mm. Three uteri had fibroids that measured less than 2cm; two uteri had focal adenomyosis. No myometrial perforations or thermal serosal injuries
