Pathologic Characteristics of Hysterectomy Specimens in Women Undergoing Hysterectomy after Global Endometrial Ablation

Study ObjectiveTo describe uterine pathologic features in women who underwent hysterectomy because of failed global endometrial ablation (GEA).DesignRetrospective cohort study from 1998 through 2005 (Canadian Task Force classification III).SettingTertiary referral center.PatientsSixty-nine women who underwent hysterectomy because of GEA failure.InterventionsPathology reports were available for 67 patients. Descriptions of hysterectomy specimens after GEA were reviewed.Measurements and Main ResultsRates of pathologic findings in hysterectomy specimens after failed GEA were determined. Reasons for hysterectomy in the 67 patients with available pathology reports were bleeding in 34 (51%), pain in 19 (28%), and bleeding and pain in 14 (21%). The pathology reports of these specimens showed leiomyomas in 33 specimens (49%); intramural myomas were present in 15 women (44%) who underwent hysterectomy because of bleeding and 8 women (42%) who underwent hysterectomy because of pain. Hematometra was identified in 7 pathologic specimens (10%). Specifically, hematometra was identified in specimens from 5 of 19 women who underwent hysterectomy because of pain (26%).ConclusionHematometra was a significant finding in women who underwent hysterectomy because of persistent pain after GEA. A possible pathologic predictor of GEA failure may be intramural leiomyomas.