Thermal Balloon Endometrial Ablation in the Treatment of Heavy Menstrual Bleeding

Bouzari, Zinatossadat; Yazdani, Shahla; Azimi, Samira; Delavar, Mouloud Agajani

doi:10.5455/medarh.2014.68.411-413

Cited by 10 publications

(8 citation statements)

References 19 publications

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“…Endometrial ablation (EA) is one of the treatment options for this common complaint. Due to the low costs and less invasive nature of this procedure (lower intra-operative complication risks, shorter recovery time, and lower post-operative morbidity), this form of treatment seems to be a less invasive surgical treatment for menorrhagia compared to hysterectomy [2][3][4][5][6]. However, long-term follow-up shows a decrease in patient satisfaction and treatment efficacy.…”

Section: Introductionmentioning

confidence: 99%

Prediction of unsuccessful endometrial ablation: random forest vs logistic regression

et al. 2021

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Background Five percent of pre-menopausal women experience abnormal uterine bleeding. Endometrial ablation (EA) is one of the treatment options for this common problem. However, this technique shows a decrease in patient satisfaction and treatment efficacy on the long term. Study objective To develop a prediction model to predict surgical re-intervention (for example re-ablation or hysterectomy) within 2 years after endometrial ablation (EA) by using machine learning (ML). The performance of the developed prediction model was compared with a previously published multivariate logistic regression model (LR). Design This retrospective cohort study, with a minimal follow-up time of 2 years, included 446 pre-menopausal women (18+) that underwent an EA for complaints of heavy menstrual bleeding. The performance of the ML and the LR model was compared using the area under the receiving operating characteristic (ROC) curve. Results We found out that the ML model (AUC of 0.65 (95% CI 0.56–0.74)) is not superior compared to the LR model (AUC of 0.71 (95% CI 0.64–0.78)) in predicting the outcome of surgical re-intervention within 2 years after EA. Based on the ML model, dysmenorrhea and duration of menstruation have the highest impact on the surgical re-intervention rate. Conclusion Although machine learning techniques are gaining popularity in development of clinical prediction tools, this study shows that ML is not necessarily superior to the traditional statistical LR techniques. Both techniques should be considered when developing a clinical prediction model. Both models can identify the clinical predictors to surgical re-intervention and contribute to the shared decision-making process in the clinical practice.

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Section: Introductionmentioning

confidence: 99%

Prediction of unsuccessful endometrial ablation: random forest vs logistic regression

et al. 2021

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“…Heavy menstrual bleeding is a common problem in women (1). Post-menopausal bleeding that occurs 1 year after the permanent cessation of menstruation is considered abnormal and must be examined (2,3).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Three Clinical Models for Estimating the Risk of Endometrial Cancer in Post-Menopausal Women with Abnormal Vaginal Bleeding

et al. 2018

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Background: Given the prevalence of abnormal post-menopausal bleeding and the importance of its early examination for ensuring the timely diagnosis of any malignancies, the present study was conducted to investigate uterine pathologies in relation to post-menopausal bleeding patterns and endometrial thickness as observed in transvaginal ultrasounds and to offer models for predicting endometrial cancer. Methods:The present descriptive-analytical cross sectional study was conducted on 112 post-menopausal women presenting to Ayatollah Rouhani Hospital in Babol, Iran. The patients underwent a transvaginal ultrasound and hysteroscopy and their samples were sent for pathological examination. The logistic regression model and the receiver operating characteristic (ROC) curve were used. This study presents 3 models for predicting endometrial cancer, including AM30 [which considers the subject's amount of bleeding, Menopause age and BMI (Body Mass Index) for assessing her risk of endometrial cancer], AMD30 (which additionally considers the subject's history of diabetes) and AMDI30 (which additionally considers the subject's history of internal diseases).Results: Menopause age, amount of bleeding, BMI, and history of internal diseases were significantly linked to endometrial cancer in post-menopausal women with abnormal bleeding; that is, the variables were higher in this group than in those without cancer (P = 0.007, P = 0.004, P = 0.001, and P = 0.02). The three models defined, i.e. AM30, AMD30, and AMI30 had a high area under the ROC curve and could predict endometrial cancer with a proper sensitivity and specificity in post-menopausal women with vaginal bleeding. There were no statistically significant differences among these models, although the AMI30 model had a higher area under the ROC curve compared to the other two models (P = 0.29). Conclusions:The present study recommends these three predictive models as alternatives for predicting endometrial cancer in post-menopausal women with vaginal bleeding.

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“…Four thermal endometrial balloon ablation systems are currently used, yet in developing countries, most of these technologies are not easily available to the public. However, effectiveness and accessibility of ThermaChoice and Cavaterm have been tested in India and Iran, with satisfactory results (27, 28). In a recent randomized controlled trial, no significant difference was observed in quality of life, hysterectomy rates, and patient satisfaction 5 years after treatment with MEA™ compared to Thermachoice 3.…”

Section: Introductionmentioning

confidence: 99%

Electrosurgery and clinical applications of electrosurgical devices in gynecologic procedures

Aminimoghaddam

Pahlevani

Kazemi

2018

Med. J. Islam. Repub. Iran

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Background: Electrosurgery is widely used in reproductive related surgeries and technological advancements to improve efficacy and reduce potential complications. However, some reports have indicated lack of sufficient knowledge and training about basic principles and technical aspects of electrosurgery among obstetricians and gynecologists. Methods: In this paper we present a summary on basic concepts and principles of electrosurgery and review the recent evidence on the use of electrosurgical devices in gynecologic procedures including endometrial ablation, gynecologic malignancies, loop electrode excision procedure (LEEP), and infertility. Result: Considering the extensive use of these technologies in reproductive related surgeries, procedures including laparoscopy, hysteroscopy, and loop procedures further highlights the importance of more detailed training in this field. Gynecologists must learn the basics in more detail and update their knowledge on the growing body of evidence regarding the advancements of these technologies to reduce potential complications and select the most cost-effective treatment options for each patient. Conclusion: Try to understanding the underlying biophysical principles and more in-depth familiarity with various electrosurgical devices could lead to less complications and optimize evidence-based gynecological practice.

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Thermal Balloon Endometrial Ablation in the Treatment of Heavy Menstrual Bleeding

Cited by 10 publications

References 19 publications

Prediction of unsuccessful endometrial ablation: random forest vs logistic regression

Prediction of unsuccessful endometrial ablation: random forest vs logistic regression

Comparison of Three Clinical Models for Estimating the Risk of Endometrial Cancer in Post-Menopausal Women with Abnormal Vaginal Bleeding

Electrosurgery and clinical applications of electrosurgical devices in gynecologic procedures

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