Indication
Persistent bleeding disorders in the premenopause and wish for preservation of the uterus.
Technique
Inspection of the uterine fundus. 
Inspection of the right tubal ostium. 
Inspection of the left tubal ostium. 
Overview of the uterine cavum. 
Begin of the endometrial resection at 6 o’ clock. 
Endometrial resection. 
Normal appearance after removal of endometrial chips. 
The uterine cavum at the end of the resection. 
Ablation with the rollerball of the fundus and tubal ostia. 
Image after the ablation of the tubal ostium.
Contraindications
- Current or planned future pregnancy.
- Endometrial hyperplasia or malignancy.
- Current pelvic infections.
Complications
- TUR-Syndrome.
- Perforation or other hysteroscopy complications.
Postoperative Management
- Early discharge.
- Postoperative instructions.
- Follow-up in 1 week.
- Suggest contraception, since a subsequent pregnancy may have serious complications.
Bibliography
- Leathersich, S. J., & McGurgan, P. M. (2018). Endometrial resection and global ablation in the normal uterus. Best Practice & Research Clinical Obstetrics & Gynaecology, 46, 84–98. https://doi.org/https://doi.org/10.1016/j.bpobgyn.2017.09.006
- Kohn, JR, Shamshirsaz, AA, Popek, E, Guan, X, Belfort, MA, Fox, KA. Pregnancy after endometrial ablation: a systematic review. BJOG 2018; 125: 43– 53.
Gynaecologia 