Thermal balloon endometrial destruction: the outcome of treatment of 117 women followed up for a maximum period of 4 years

Abstract

Objective To study the long‐term results of treatment for menorrhagia involving the thermal destruction of the endometrium by means of a balloon catheter. Design Between August 1993 and December 1996, 117 women were treated and, in a prospective study, 116 (99%) of them were followed up with consultations and questionnaires. No pretreatment with gonadotrophin‐releasing hormone (GnRH) analogues was given. Setting Gynaecology department at a university hospital. Results There were no immediate peroperative complications. The success rate after 25 months (range 10–49) was 94%, excluding women with preoperative intracavitary changes and pretreatment ultrasonographically identified submucosal leiomyomas. Life‐table analysis showed that the probability of assessing the treatment as ‘excellent’ or ‘good’ and avoiding hysterectomy over a 49‐month period was 81%, and the probability of avoiding hysterectomy over the same time period was 85% when no exclusions were made. Conclusions For women with menorrhagia, who have no further wish for pregnancy, this study shows that thermal endometrial destruction by means of the balloon catheter technique is a safe type of day case procedure with a high success rate. Pretreatment examination is important in order to select women well suited for the treatment. A successful result 1 year after treatment implies a successful result in the long term.

Outcome of the first 220 cases of endometrial balloon ablation using Cavaterm™plus

“…Results of the present study compare favourably with those reported after both hysteroscopic first-generation methods for endometrial ablation such as endometrial resection, rollerball and Nd-YAG laser ablation (Magos et al, 1991;Garry et al, 1995;Goldrath, 1995;Valle, 1995;Friberg et al, 1996;O'Connor and Magos, 1996) and second-generation ablation methods such as Thermachoice TM , NovaSure TM and hydrothermal ablation (Amso et al, 1998;Meyer et al, 1998;Friberg and Ahlgren, 2000;Corson, 2001;Hefni et al, 2002;Abbott et al, 2003). Also, the low failure rate observed in the present study was comparable to those reported previously with the use of either first-or secondgeneration techniques of endometrial ablation (Pinion et al, 1994;O'Connor andMagos, 1996, Phillips et al, 1998;Hefni et al, 2002).…”

“…First, the diameter of the device's catheter is smaller (6 mm) compared to 9 mm in the older version, thus obviating the need for cervical dilatation in most cases and allowing the procedure to be performed under local anaesthesia (Friberg and Ahlgren, 2000), although this was not preferred by our patients. Secondly, the balloon length is more adjustable to the cavity, thus adapting to a wider variety of cavity configurations.…”

Endometrial ablation with the Cavaterm™ thermal balloon

“…Compared to other thermal balloon systems such as Thermachoice TM and Easy TM , although results are similar (Amso et al, 1998;Meyer et al, 1998;Friberg and Ahlgren, 2000), the Cavaterm TM differs in three important respects. First, the balloon is made of silicone rather than latex, which renders it highly flexible and more robust.…”

“…The Cavaterm can also be used under local anaesthesia (Friberg and Ahlgren, 2000), although this was not preferred by our patients.…”

Endometrial Ablation: Where Have We Been? Where Are We Going?

“…A number of the reports emanate from 1 group, with the most recent update describing 106 of the 117 originally treated women 10 to 49 months after treatment. 73,74 The hysterectomy rate during the follow-up period was 8.6% (10/116) with 7 cases associated with submucosal leiomyomas. The amenorrhea rate was 29.4% but 7 of these patients were postmenopausal at the time of follow-up.…”