Sonographic findings after surgical ablation of the endometrium

Endometrial ablation is a new surgical technique that is an alternative to hysterectomy in women with dysfunctional uterine bleeding. The endometrium is either coagulated or resected in an attempt to render the patient amenorrheic. Because of the newness of the procedure, no report of radiologic findings after endometrial ablation has been published. Accordingly, the sonographic appearance of the uterus after endometrial ablation is described. Using transvaginal sonography, we examined a select group of 16 women, seven of whom were symptomatic after endometrial ablation. All patients had a preoperative diagnosis of menorrhagia not responsive to conventional hormonal therapy and no evidence of cancer. In the seven symptomatic patients, sonography showed that postoperatively two had hematometra, one had a nonviable intrauterine pregnancy, and four had residual islands of functioning endometrial tissue alone or in combination with hematometra. In nine asymptomatic patients, postoperative sonography showed seven had normal findings except for leiomyomata and two had residual islands of functioning endometrial tissue. Sonographic examination of the uterus after endometrial ablation provides a method for evaluating symptomatic patients and for identifying any remaining endometrium that could later become symptomatic.