Endometrial ablation: the next generation

Kremer, Christian; Duffy, Sean

doi:10.1111/j.1471-0528.2000.tb11667.x

Cited by 11 publications

(11 citation statements)

References 60 publications

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“…Several authors have questioned the validity, safety and patient satisfaction associated with some second‐generation devices, 38 saying that none fulfil all the criteria of a simple, safe technique that works and that can be performed in an outpatient setting. One criticism of this survey is that no information was collected on the method of anaesthesia/analgesia used.…”

Section: Discussionmentioning

confidence: 99%

A European survey of the complications of a uterine thermal balloon ablation system in 5800 women

Rogerson

Duffy

2002

Gynaecol Endoscopy

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Objective To study the nature and incidence of complications, and the ease of use associated with a uterine thermal balloon system. Design An anonymous postal questionnaire with no follow up for non‐responders. Setting European survey throughout the UK, France, Switzerland and the Netherlands. Sample All users of the ThermaChoice uterine thermal balloon system in the countries stated. Main outcome measures These were the number of procedures performed by respondents throughout Europe; the nature and incidence of intraoperative and postoperative complications, and the perceived ease of use and safety of the thermal balloon system. Results 446 questionnaires were mailed, and there were 149 responses (33.4%). From the returned questionnaires it is possible to report on an estimated 5859 procedures performed throughout Europe. In this series, there were 14 reported intraoperative complications (0.24%), two emergency procedures, and a total of 230 postoperative complications (3.92%). This gives an overall complication rate of 4.16%. Conclusions This survey found that the ThermaChoice system is widely used throughout Europe. Although the methodology of this retrospective study has limitations, it has shown that the system has an excellent safety record, and notably that the complication rate appears to be lower than that observed for traditional ablation techniques as reported in the MISTLETOE study. Clinicians employing this system perceive it to be very safe and easy to use compared with traditional transcervical resection of endometrium. For the future, it is important to prospectively collect this data in order to gain the same information for the second‐generation devices, as is available for the ‘gold standard’ techniques for endometrial ablation.

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Section: Discussionmentioning

confidence: 99%

A European survey of the complications of a uterine thermal balloon ablation system in 5800 women

Rogerson

Duffy

2002

Gynaecol Endoscopy

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“…18,26 The therapeutic techniques that were included in the assessments are: (a) roller-ball ablation, (b) liquidbased ablation, (c) radiofrequency heating, (d) microwave heating, (e) bipolar ablation, and (f) laser ablation. These assessments did not reach a definitive conclusion as to the superiority of any one of these techniques.…”

Section: Discussionmentioning

confidence: 99%

A Simulation of Gas-Based, Endometrial-Ablation Therapy

Sparrow

Abraham

2007

Ann Biomed Eng

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The method of numerical simulation has been employed to evaluate the use of a gas as a heating medium for endometrial ablation for the treatment of menorrhagia and uterine fibroids. The simulations encompassed fluid flow and heat transfer within the gaseous medium which serves to heat the uterine lining and the coupled heat conduction in the uterine tissue. For the case study featured here, helium at a temperature of 140 degrees C was employed as the heating medium. A total therapy duration of 6 min was modeled. The outcome of the simulation has provided quantitative information about the detailed necrosis depths that can be attained by the application of the therapy. In particular, necrosis depths on the order of 5 mm were achieved. It was also shown that by making use of a tailored pattern of fluid flow within the uterine cavity, particular zones on the uterine lining such as fibroids can be selectively targeted. Furthermore, the duration of the therapy needed to achieve a desired degree of necrosis can be predicted in advance. The advantages of a gas-based therapy relative to a liquid-based therapy are identified. Significant among these is the capability of the gas-based therapy to target specific zones which require treatment, while sparing healthy tissue. Another significant advantage of gas-based therapy is that it enables the use of higher temperatures which, in turn, allows the therapeutic process to be performed in a shorter time duration.

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“…1,19 Although both of these treatment options have been compared to various medical and surgical therapies there have been no studies comparing these two alternatives. 2,5,8,10,11,13,18,20 Recently the SMART study (Satisfaction with Mirena ® ‚ and Ablation: a Randomised Trial), a multicentre randomised control trial comparing LNG-IUD with MEA™, was halted due to subject reluctance to be randomised. 21,22 The aim of the study was to perform a pragmatic retrospective cohort study comparing LNG-IUD with MEA™ in the treatment of heavy menstrual loss.…”

Section: Discussionmentioning

confidence: 99%

“…Heavy menstrual bleeding is a major clinical problem, with significant effects on quality of life. [1][2][3] It accounts for around 12% of all referrals to gynaecology outpatients in Australia and other western countries. 4,5 Menorrhagia is defined as a blood loss of greater than 80 mL each cycle but it is usually women's perception of their own bleeding which dictates referral and subsequent treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Used originally as a contraceptive method, it has been shown to reduce menstrual blood loss by up to 90% with 85% satisfaction. 2,5,[11][12][13] It has also been shown to reduce the frequency of clotting, flooding and dysmenorrhoea, and to improve quality of life. 14,15 The second treatment, microwave endometrial ablation (MEA™), has shown an 88% satisfaction rate with 40% amenorrhoea and a 95% rate of improvement in dysmenorrhoea.…”

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confidence: 99%

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