Perioperative complication rates of primary and repeat hysteroscopic endometrial ablations.

STUDY OBJECTIVE: To determine perioperative complication rates at primary and repeat endometrial ablations.

DESIGN: Prospective cohort study (Canadian Task Force classification II-2).

SETTING: Tertiary care teaching hospital.

PATIENTS: Seventy-five women who underwent a repeat ablation and 800 who had a primary ablation by the same surgeon (GAV) between 1990 and 2000 for a diagnosis of menorrhagia and/or dysmenorrhea.

INTERVENTIONS: Hysteroscopic ablation involving coagulation or resection of endometrium, and second ablation after failure of the first.

MEASUREMENTS AND MAIN RESULTS: Serious perioperative complications were uterine perforation, hemorrhage, excess fluid absorption, and genital tract burns. They occurred in 9.3% of repeat ablations compared with 2.05% of primary ablations (p = 0.006).

CONCLUSION: Repeat endometrial ablation has a significantly higher rate of perioperative complications than primary ablation.