Endometrial thermoablation for treatment of menorrhagia: comparison of two methods in outpatient setting

Vihko, Kimmo K.; Raitala, Reijo; Taina, Esko

doi:10.1080/j.1600-0412.2003.00110.x

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Thermal ablation is associated with a complication rate of about 0–13%, hysteroscopic about 6–25% (A) (79), (99). The techniques for endometrial destruction give equal results with regard to therapy outcome and patient satisfaction (A) (64), (93), (99), (110), (111). Preoperative administration of a GnRH analogue increases amenorrhoea during the first year after the procedure, but in the longer term there are no differences in menstrual blood loss compared with women who took no preoperative treatment (A) (106).…”

Section: Guidelinementioning

confidence: 99%

Diagnosis and treatment of menorrhagia

Hurskainen

Grénman

Komi

et al. 2007

Acta Obstet Gynecol Scand

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One-third of all women experience heavy menstrual bleeding at some point in their life. In western countries, about 5% of women of reproductive age will seek help for menorrhagia annually. Half of all women who consult for hypermenorrhea have some uterine abnormality, most often fibroids (among patients under 40 years of age) and endometrial polyps (above 40 years of age). Appropriate treatment considerably improves the quality of life of these patients, and it is important to make a rigorous assessment of the patient to provide the best treatment options. This guideline provides instructions on how to examine and treat women of fertile age who have menorrhagia. The subject's own assessment of the amount of menstrual blood loss does not generally reflect the true amount. All patients should undergo a pelvic examination and, if the menstrual pattern has changed substantially or if anaemia is present, a vaginal sonography should be carried out as the most important supplemental examination. Vaginal sonography combined with an endometrial biopsy is a reliable method for diagnosing endometrial hyperplasia or carcinoma, but it is insufficient for diagnosing endometrial polyps and fibroids; these can be diagnosed more reliably by sonohysterography or hysteroscopy. Non-steroidal anti-inflammatory drugs and tranexamic acid reduce menstrual blood loss by 20-60%, and the effectiveness of a hormonal intrauterine system (IUS) is comparable with that of endometrial ablation or hysterectomy. Cyclic progestogens do not significantly reduce menstrual bleeding of women who ovulate. Treatment should be started with one of the drug therapies, i.e. the IUS, tranexamic acid, anti-inflammatory drugs, or oral contraceptive. Drug treatment should be used and evaluated before surgical interventions are considered. With an effective training and feedback system, it is possible to organise the diagnostics, medical treatment and follow-up of heavy menstrual bleeding in the primary health care setting or in outpatient clinics, which reduces the burden on specialist health care.

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Section: Guidelinementioning

confidence: 99%

Diagnosis and treatment of menorrhagia

Hurskainen

Grénman

Komi

et al. 2007

Acta Obstet Gynecol Scand

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“…There is only one small observational study in the literature regarding the effectiveness of this device reporting an amenorrhea rate of 10% at 1 year follow-up [59], and just one small randomized control study comparing Menotreat® and Cavaterm® [60], reporting amenorrhea rates up to 19% in the Menotreat® group and up to 13% in the Cavaterm® group.…”

Section: Second-generation Endometrial Ablation Techniquesmentioning

confidence: 99%

Treatment options for dysfunctional uterine bleeding: evaluation of clinical results

et al. 2011

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Abnormal uterine bleeding is one of the most common problems in women of reproductive age, and dysfunctional uterine bleeding (DUB) accounts for about half the cases. The aim of this review is to present all treatment options for women suffering from DUB and to evaluate their effectiveness. A detailed search strategy on electronic databases was carried out to identify trials and reviews on management of abnormal uterine bleeding. Tranexamic acid is the most effective medical treatment. A levonorgestrel-releasing intrauterine device is a low-cost, simple, and effective medical method, comparable to hysterectomy in terms of quality of life. In cases of DUB resistant to medical treatment, surgical treatment should be offered. First-generation ablation techniques are effective, but have a long learning curve. Second-generation ablation devices are highly effective and safe alternatives, thoroughly compared to first-generation techniques. Hysterectomy is the only method that guarantees treatment of dysfunctional uterine bleeding, but is a major operation associated with higher morbidity and mortality rates. Proper counseling of each woman with DUB regarding all treatment modalities can provide the best choice for each patient. More prospective randomized trials are needed to establish the effectiveness of these methods

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“…В 1990-е годы появились негистероскопические методики аблации эндометрия 2-го поколения, к которым относится баллонная термоаблация. Клиницисты [17,26,28] отметили их высо-кую эффективность (89-100 %) при небольшом количестве осложнений. До настоящего времени остаются нерешенны-ми ряд проблем, связанных с применением термоаблации эндометрия.…”

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Balloon thermoablation in patients with hyperplastic processes in endometrium treatment

Бреусенко

Mishieva²,

Golova

et al. 2013

Z.akus.zen.bolezn

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The experience of treatment of 84 menstruating and postmenopausal patients with hyperplastic processes in endometrium is analyzed in the study. Balloon thermoablation of endometrium using TERMOCHOICE sistem was performed. Clinical effectiveness of ablation was assessed during 12, 24, 36 months. The effectiveness of thermoablation in menstruating women was 83,1 %, in menopause patients 100 %. The technique is safe, effective and uterus-preserving.

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Endometrial thermoablation for treatment of menorrhagia: comparison of two methods in outpatient setting

Cited by 5 publications

References 14 publications

Diagnosis and treatment of menorrhagia

Diagnosis and treatment of menorrhagia

Treatment options for dysfunctional uterine bleeding: evaluation of clinical results

Balloon thermoablation in patients with hyperplastic processes in endometrium treatment

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