Prediction of successful menorrhagia treatment after thermal balloon endometrial ablation.

Abstract

BACKGROUND:

Thermal balloon endometrial ablation (TBEA) is a non-hysteroscopic technique, which relies on a combination of heat and pressure within the uterine cavity to destroy endometrium and superficial myometrium. It is a simple, easy and minimally invasive procedure with an equivalent effectiveness to hysteroscopic endometrial ablation.

OBJECTIVES:

To evaluate the effectiveness of TBEA in the treatment of menorrhagia and to identify the possible predictive factors for a successful outcome after 2-year follow-up.

METHODS:

A prospective study was conducted, including 45 patients suffering from serious menorrhagia. Under local anesthesia with i.v. sedation, the Therma-Choice trade mark (Gynecare, Somerville, NJ, USA) balloon was inserted transcervically and after inflation in the endometrial cavity with 5% dextrose, it was heated to 87 degrees C for an 8-minute treatment cycle.

RESULTS:

There were no intraoperative complications and postoperative morbidity was minimal. At 2-year follow-up the overall improvement of menstrual pattern was 85%; with reported 29% amenorrhea, 23.5% hypomenorrhea and 32.5% euomenorrhea. Menorrhagia persisted in 15% of patients. Multiple logistic regression analysis of the factors that could affect the outcome showed that the chance for a successful treatment increased significantly with increased age (P = 0.044), shorter uterine depth (P = 0.049) and adequate balloon pressure (P = 0.027). These were the predictive factors for successful outcome. However, parity, uterine volume and endometrial thickness were not predictive factors.

CONCLUSION:

At 2-year follow-up, thermal balloon endometrial ablation is effective in menorrhagia treatment. Increased age, shorter uterine depth and adequate balloon pressure can be predictive factors for successful treatment.

• Authors: Ayman H Shaamash, Ezzat H Sayed
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 30 Issue 3 Pg. 210-6 (Jun 2004) ISSN: 1341-8076 [Print] Australia
• PMID: 15210045 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Catheter Ablation (methods)
• Catheterization (methods)
• Endometrium (surgery)
• Female
• Hot Temperature
• Humans
• Menorrhagia (pathology, therapy)
• Middle Aged
• Minimally Invasive Surgical Procedures (methods)
• Pressure
• Prospective Studies
• Treatment Outcome