Outpatient endometrial ablation: audit of outcomes and patient satisfaction

Ajmi, Ayesha; Sangeeta, Das

doi:10.1080/01443615.2019.1700945

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…The current study has much higher satisfaction rate (90%) with comparison to those studies. Ayesha A et al also reported in their study on audit of outcomes and patient satisfaction in outpatient endometrial ablation in 2020, as 90% 29 . If further studies demonstrate the safety of the procedure and the feasibility of carrying it out under LA, it could be carried out as an outpatient procedure and patient satisfaction may also be improved.…”

Section: Patient Satisfaction After Treatment With Thermal Balloonmentioning

confidence: 88%

Thermal endometrial ablation for abnormal uterine bleeding due to endometrial pathology: an alternative to hysterectomy

Dasanayake¹,

Goonewardenea²

2020

Sri Lanka J Obstet & Gynae

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Introduction: Among women of reproductive age Abnormal Uterine Bleeding (AUB) due to a primary endometrial pathology (AUB-E) occurs in up to 25%, and it has a significant adverse impact on their quality of life. In Sri Lanka, hysterectomy continues to be the commonest modality for the treatment of AUB-E not responding to medical therapy. Thermal Endometrial Ablation (TEA) is an alternative option for the management of women with AUB-E. Objective: To describe the effectiveness, short and long term complications, patient satisfaction and cost of TEA in the management of women with AUB-E in Sri Lankan setting. Method: Thirty women with AUB-E underwent TEA under regional anaesthesia at the Academic Department of Obstetrics and Gynaecology of the Teaching Hospital Mahamodara, Galle (THMG) during the period of November 2012 to April 2015. Data was collected using an interviewer administrated questionnaire at discharge, two weeks, three, six, 12 and 24 months post procedure. The effectiveness, short and long term complications, patient satisfaction and cost of TEA in the management of women with AUB-E were studied. Abdominal Hysterectomy (AH) was offered for the patients with treatment failure. Result: Mean age and Body Mass Index of the women were 46 years (SD 4.8) and 25 Kg/m 2 (SD 2.3) respectively. Short term minor complications (abdominal cramps, excessive vaginal discharge and vomiting) were observed in three women (10%). There were no major complications. At the end of 12 months, almost half the women were amenorrhoeic with an improvement rate of 90%. At the end of the two years seven (23%) had amenorrhoea and 20 (67%) had reduced per vaginal bleeding. Three women underwent AH at three, six and 12 months post procedure respectively, due to treatment failure. The approximate cost of an AH was LKR 49,000. The cost of one TEA device and one TEA installation system were LKR 120,000 and LKR 4,500,000 respectively. Conclusion: TEA was an effective alternative to AH for the treatment of AUB-E, and had no major complications. However, it was more expensive when compared to AH.

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Section: Patient Satisfaction After Treatment With Thermal Balloonmentioning

confidence: 88%

Thermal endometrial ablation for abnormal uterine bleeding due to endometrial pathology: an alternative to hysterectomy

Dasanayake¹,

Goonewardenea²

2020

Sri Lanka J Obstet & Gynae

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“…Second, that simple polypectomy carries a considerable risk of recurrence; Third, that polypectomy alone is frequently insufficient to manage AUB satisfactorily. Third, that polypectomy alone is frequently insufficient to manage AUB satisfactorily, [22].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Hysteroscopy in Management of Premenopausal Uterine Bleeding at Tanta University Hospitals

Hegazy

Elshwaikh

Shoeir

et al. 2022

JAMMR

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Background: Hysteroscopy is a minimally invasive procedure that may be used to analyse data and treat a variety of intrauterine and endocervical issues. The purpose of this work was to evaluate the hysteroscopic diagnostic findings and therapeutic efficacy of hysteroscopy in females with premenopausal uterine bleeding at Tanta University Hospitals. Methods: This was a prospective cohort observational research enrolled 60 premenopausal females aged from 40 to 52 years and presented with abnormal uterine bleeding. All patients were subjugated full history taking, clinical examination (general examination, pelvic examination and abdominal examination) and investigations (laboratory tests including full blood count, thyroid, iron studies, hemostasis disorders, transvaginal ultrasound to evaluate any organic lesion and hysteroscopy). Results: The success rate of hysteroscope was 100% in in grade I fibroid uterus and was 30% and 0% in grade II and grade III fibroid uterus. 75% of atrophic endometrium, 71% of secretory endometrium, 50% of proliferative endometrium, 100% of hyperplastic endometrium and 100% of endometrial polyp. Conclusions: The gold standard for diagnosing and treating abnormal uterine bleeding is hysteroscopy in the premenopausal period especially of fibroid uterus and endometrial polyp.

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“…With new second-generation devices, which enable shorter treatment times, it has become more practical to perform the procedure in outpatient setting. Gynaecologists should continue to offer outpatient endometrial ablation to appropriately selected patients with abnormal uterine bleeding, with adequate counselling regarding possible pain and discomfort and alternative options [25].…”

Section: Outpatient Endometrial Ablationmentioning

confidence: 99%

Advances in Outpatient Hysteroscopy

Ajmi¹

2022

Ultimate Guide to Outpatient Care

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Hysteroscopy is a gynaecological procedure that has developed into an important tool to identify endometrial abnormality. It offers direct examination of the uterine cavity and tubal ostia and offers the option of performing targeted biopsy of suspected lesions that can be missed by blind procedures. In a large number of cases, the intrauterine lesions can be diagnosed and treated at the same setting as one step approach (“see and treat”). For example, endometrial polyps can be identified and removed; intrauterine adhesions may be divided in the office owing to the practicability of operative saline hysteroscopy, vaginoscopic approach and the convenience of miniature hysteroscopes. There is decent evidence that hysteroscopy in the outpatient clinic setting is preferred by the patients, associated with low risk of complications, quicker recovery time and reduced cost. Technological advances have led to development of high definition miniature hysteroscopes without negotiating optical performance, and hence making hysteroscopy an ingenuous, safe and trusted office procedure. Recent advances such as bipolar electrosurgery, endometrial ablation devices, morcellators and tissue retrieval system has transformed the surgical technique. This modernization of hysteroscopy completely revolutionised the approach to the management of intrauterine pathologies, moving from a blind procedure under general anaesthesia to directly visualised procedure under no or local anaesthesia, offering diagnostic as well as therapeutic procedures that should be at the disposal of every modern gynaecologist.

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Outpatient endometrial ablation: audit of outcomes and patient satisfaction

Cited by 5 publications

References 13 publications

Thermal endometrial ablation for abnormal uterine bleeding due to endometrial pathology: an alternative to hysterectomy

Thermal endometrial ablation for abnormal uterine bleeding due to endometrial pathology: an alternative to hysterectomy

Efficacy of Hysteroscopy in Management of Premenopausal Uterine Bleeding at Tanta University Hospitals

Advances in Outpatient Hysteroscopy

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