April 5th, 2020

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Postablative Risk of Endometrial Carcinoma in New Zealand White Rabbits Given High-Dose Estrogen
Authors:  Gary M. Horowitz, M.D., Scott Christensen, M.D., Caroline Kennebeck, M.D., and R. Leon Graham, M.D.
  OBJECTIVE: To follow a population at high risk for endometrial carcinoma after endometrial ablation, to determine if ablation alters the incidence or detection of endometrial pathology.

STUDY DESIGN: The animal model included 33 New Zealand white rabbits. Of this cohort, 17 underwent surgical ablation of the endometrium via laparotomy, while 16 served as controls. Vaginal bleeding was assessed with monthly cotton swab examinations as well as daily observation of the subjects. All animals received unopposed estrogen for 18 months prior to necropsy.

RESULTS: No animal in either arm of the study demonstrated vaginal bleeding. Two rabbits from the ablation group and three controls showed histologic evidence of atypical endometrial hyperplasia or adenocarcinoma (P>.20). One additional animal from each group had hyperplasia without atypia.

CONCLUSION: This animal model suggests that endometrial ablation does not decrease the risk of endometrial carcinoma in patients at high risk of developing endometrial pathology. Detection of hyperplasia or carcinoma in such a population may prove difficult due to the absence of traditional signs of endometrial abnormalities. (J Reprod Med 2000;45:553-556)
Keywords:  endometrial neoplasms, estradiol, endometrial ablation, dysfunctional uterine bleeding
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