Abnormal Uterine Bleeding Control by Sequential Application of Hysteroscopic Lesion Morcellation and Endometrial Ablation

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The article in the Journal of Reproductive Medicine (JRM) titled “Abnormal Uterine Bleeding Control by Sequential Application of Hysteroscopic Lesion Morcellation and Endometrial Ablation” represents a significant advance in medicine and women’s healthcare.

The article’s lead author, Dr. Robert Rubino, founder of the Rubino OBGYN Group, has an interest in reducing the need for hysterectomies by implementing conservative, minimally invasive technology to address pathological uterine bleeding and hemorrhage in women. The problem is often due to uterine fibroids or polyps.

Dr. Rubino headed a national, multi-center trial, which combined two new procedures simultaneously instead of the traditional approach, involving separate surgeries spread out over time.

“Typically, women who suffer from pathologically heavy menstrual flow often have fibroids and polyps as the cause as well as an abnormality of the uterine lining called ‘adenomyosis,’” explains Dr. Rubino. “In the past, it has been considered too risky to remove a fibroid or polyp and then ablate (destroy) the uterine lining at the same time for concerns of complications and postoperative scarring. Based on follow up from a prior research article published in the Journal of Minimally Invasive Gynecology (JMIG, 2015; 22:285-290) it became clear that hysteroscopic morcellation is quite safe and a combined procedure with ablation may be possible.”

The study looked at 26 patients at several centers across the US who suffered from heavy, abnormal uterine bleeding who had polyps or fibroids in the uterine cavity. Instead of the patients having the masses removed in one surgery and coming back several months later to have the uterine lining ablated with a thermal energy device, the two surgeries were done at the same time. The patients were monitored for safety, efficacy and complications.

The results showed dramatic improvement of quality of life scores post procedure; an 87% success rate and no major complications.

Dr. Rubino continues “It is rewarding to challenge the current orthodoxy through bold research questions and get objective data to support hypothesis, this is how we move medicine forward. Patients who previously had to stretch their treatment out over several months and two surgeries, two anesthesia exposures and two leaves from work and home life now only have to go through it once and most avoid hysterectomy. To me, that is progress.”