Hysteroscopic endometrial ablation with the Nd:Yag laser using a nontouch technique.

Thirty-six patients with menorrhagia were treated with a technique for laser destruction of the endometrium in which the end of the fiberoptic guide of the Nd:Yag laser is not allowed to come in contact with the endometrium. The results were excellent in 93.9% of the 33 patients followed over three months. Amenorrhea was achieved in 11 patients, a significantly decreased menstrual flow in 13 patients, and a decrease to a normal flow in seven patients. Failure to satisfactorily control menorrhagia occurred in two patients. The technique of not touching the endometrium caused no complications in this series and may prevent the problems of fluid overload and postoperative bleeding found when contact is made with the endometrium.