Long-term results of endometrial resection

In the management of menorrhagia, endometrial ablation techniques or intra-uterine progesterone-containing devices are employed when medical therapy fails. We postulated that the insertion of a Mirena IUS at the time of a TCRE would improve upon the success rates found when either is user individually. In a small pilot study, we identified patients who had both a TCRE and Mirena over a 26 month period. Those younger than 45, with a follow-up period of one year formed the final study group of 18. There were high rates of patient satisfaction, with a significant reduction in menstrual bleeding in the majority of patients. An amenorrhoea rate of 67% was achieved, which is significantly higher than the rates found with either TCRE or Mirena alone.

Section: Discussionmentioning

confidence: 99%

“…The reported amenorrhoea rates for TCRE and Mirena alone are quite similar, with 23-45% of TCRE patients [4][5][6][7][11][12][13] and 20-50% of those with a Mirena [1] reporting a complete absence of menstrual periods. When TCRE and Mirena are combined, the amenorrhoea rate was significantly higher, 67%.…”

Section: Discussionmentioning

confidence: 99%

TCRE and Mirena: is the combination better?

Low

Smith

2006

“…The presence of myomas, especially submucous and intramural >3 cm, or the suspicion of adenomyosis, are likely to reduce success [16]. Rates of success with thermal balloon ablation have paralled other ablation techniques with 80-90% patient satisfaction expected [17,18]. Long-term follow-up studies on balloon ablation continue to show highly satisfactory outcomes [19,20].…”

Section: Discussionmentioning

confidence: 99%

Thermablate EAS: a new endometrial ablation system

Yackel¹,

Vilos

2004

Objective: To report on Thermablate EAS, the newest endometrial thermal balloon ablation system now available. Design: Thermablate EAS consists of a lightweight reusable hand-held treatment control unit (TCU) with a single use disposable catheter-balloon-cartridge system. Treatment time is <2.5 min. A 6.0-mm diameter catheter allows it to be used in an office or outpatient setting utilizing minimal anesthesia/analgesia. Results: Six-month follow-up data obtained under a Special Access Program for Health Canada in a series of 54 patients showed amenorrhea 20%, spotting 20%, hypomenorrhea 37%, eumenorrhea 16%, and persisting menorrhagia 6%. Conclusion: Thermablate EAS is the smallest, most portable, and simplest endometrial ablation presently available. High rates of clinical success and patient satisfaction combined with enthusiastic acceptance by clinicians of this compact device makes it a very attractive endometrial ablation system.

“…For repeat resections a complication rate between 9% and 15% was reported [20][21][22]. After rollerball ablation of the endometrium (without uterine perforation) one case of bowel injury was described [23].…”

Section: Commentmentioning

confidence: 99%

Small bowel perforation after thermoregulated radiofrequency endometrial ablation: a case report

Cosyns

Poots

Lind³

2006

During the past decades, numerous hysteroscopic ablation techniques have been developed for the treatment of menorrhagia, all conferring relatively comparable success rates and low complication incidences. We here report an unusual, adverse, post-operative, complication of the Vesta thermoregulated radiofrequency endometrial ablation system in a 34-year-old nulliparous woman with dysfunctional uterine bleeding. Fourteen days after the procedure she presented with acute abdominal pain. At laparotomy, a small bowel perforation was identified, and the entire uterus was found to be necrotic, necessitating a total hysterectomy. This is the first report of a severe complication of this endometrial ablation system in the absence of uterine perforation. We propose that minimal myometrial thickness should be taken into consideration to improve the safety of thermoregulated radiofrequency endometrial ablation.