Chemical ablation of endometrium with trichloroacetic acid

• Published in: International journal of gynecology and obstetrics Vol. 84; no. 1; pp. 41 - 46
• Main Authors: Kucukozkan, T., Kadioglu, B.G., Uygur, D., Moroy, P., Mollamahmutoglu, L., Besli, M.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 2004; Elsevier Science
• Subjects: Administration, Oral; Adult; Biological and medical sciences; Caustics - administration & dosage; Caustics - therapeutic use; Danazol - administration & dosage; Danazol - therapeutic use; Dilatation and Curettage; Dysfunctional uterine bleeding; Endometrial ablation; Endometrium - drug effects; Estrogen Antagonists - administration & dosage; Estrogen Antagonists - therapeutic use; Female; Goserelin - administration & dosage; Goserelin - therapeutic use; Gynecology. Andrology. Obstetrics; Humans; Injections, Subcutaneous; Medical sciences; Middle Aged; Prospective Studies; Treatment Outcome; Trichloroacetic acid; Trichloroacetic Acid - administration & dosage; Trichloroacetic Acid - therapeutic use; Uterine Hemorrhage - therapy; Trichloroacetic acid; Endometrial ablation; Dysfunctional uterine bleeding; Uterus; Gynecology; Female genital system; Ablation; Hemorrhage; Obstetrics; Endometrium
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/S0020-7292(03)00337-0

Objectives: The aim of this study was to assess the efficacy of topically applied trichloroacetic acid (TCA) for endometrial ablation in patients with dysfunctional uterine bleeding (DUB). This trial has also compared the advantages of prethinning the endometrium with danazol and goserelin acetate before ablation with TCA. Methods: This prospective trial was conducted on 90 volunteer cases. Patients were allocated into three treatment groups comprised of 30 patients. In group I cases underwent dilatation and curettage before endometrial ablation. In group II cases were administered danazol before ablation. Cases in group III received goserelin acetate on the same day and 28 days after ablation. Endometrium was evaluated by biopsy, transvaginal ultrasonography and hysteroscopy. Endometrial ablation was performed with 95% TCA. All of the patients were evaluated 3 and 6 months after TCA application. Results: After 6 months of treatment, the success rate was recorded as 83% in the first group, 92.3% in the second group and 96.6% in the third group. The mean length of uterine cavity was reduced in all groups, being only significant in Goserelin group ( P<0.5). Endometrial thickness was decreased significantly in all treatment groups ( P<0.001). Conclusions: This study concluded that endometrial ablation by TCA may readily be performed as an alternative treatment method in the management of DUB. Moreover, suppression of endometrium with danazol or especially with goserelin acetate before ablation, resulted in significant success rate.