April 5th, 2020

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Intracavitary Radiotherapy for Refractory Dysfunctional Uterine Bleeding: A Case Report
Authors:  Jennifer Cassisi, M.D., John D. Davis, M.D., Barbara B. Bennett, M.D., Frederick W. McLean, M.D., and Robert B. Marcus, Jr., M.D.
BACKGROUND: Pelvic irradiation was once a common treatment for dysfunctional uterine bleeding (DUB). Today the majority of women with DUB are successfully treated with hormonal therapy; patients unresponsive to hormonal therapy may require endometrial ablation or hysterectomy. We present a patient with severe, intractable DUB and contraindications to surgery who was treated with intracavitary radiotherapy.

CASE: A 39-year-old, 150-cm-tall, 310-kg woman was referred for management of severe DUB refractory to medical management. The bleeding was successfully treated with intracavitary cesium. Hysterectomy was not recommended due to the operative risks posed by the patient's massive obesity. Because of technical difficulties during a previous dilation and curettage and the expense of long-term GnRH agonist therapy, the patient elected to undergo intracavitary radiotherapy.

CONCLUSION: In selected patients, intracavitary radiotherapy can be used to treat DUB when conventional therapy fails or is contraindicated. (J Reprod Med 2000;45:577-580)
Keywords:  uterine hemorrhage; bleeding; radiotherapy, intracavitary; morbid obesity; dysfunctional uterine bleeding
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