Prognostic Factors for the Success of Thermal Balloon Ablation in the Treatment of Menorrhagia

Bongers, MY; Mol, Ben Willem J.; Brölmann, Hans A.M.

doi:10.1097/00006250-200206000-00020

Cited by 14 publications

(25 citation statements)

References 26 publications

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“…The long-term outcomes are derived from a high response rate (86%) which improves the accuracy of reported data. Our reported rates of amenorrhoea are consistent with other groups [3,[13][14][15] .…”

Section: Discussionsupporting

confidence: 93%

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Outpatient Thermachoice Endometrial Balloon Ablation: Long-Term, Prognostic and Quality-of-Life Measures

Varma¹,

Soneja²,

Samuel³

et al. 2010

Gynecol Obstet Invest

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Study Objective: To evaluate short- and long-term treatment outcomes of outpatient local anaesthetic thermal balloon endometrial ablation (LA-TBEA) and identify any prognostic factors. Study Design: Prospective observational study in a UK teaching hospital involving 102 menorrhagic women undergoing LA-TBEA between 2001 and 2005. Women underwent either Gynecare® Thermachoice I (n = 51) or Thermachoice III (n = 51) TBEA performed in the outpatient setting under local anaesthesia without conscious sedation. The main outcome measures were: treatment completion, pain and analgesia, duration of stay (from admission to discharge), duration of follow-up, primary treatment success and nature of any secondary treatment, menstrual symptoms and amenorrhoea, patient satisfaction, and quality of life. Results: TBEA was completed in 97% of women. Mean duration of stay was 8.0 h (95% CI 6.6–9.3). Mean follow-up was 30 months (95% CI 26–32). Secondary treatment with the levonorgestrel intrauterine system, repeat TBEA or hysterectomy occurred in 19/102 (19%). Overall, 50% of surgical re-interventions occurred by 19 months. There were high rates of amenorrhoea (29%) and treatment satisfaction (76%). Higher mean intrauterine ablation pressure was associated with increased treatment satisfaction. Conclusion: TBEA can be successfully performed in the outpatient setting. Higher endometrial ablation pressure may improve long-term treatment outcome.

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Section: Discussionsupporting

confidence: 93%

“…We believe this prospective study to be the largest cohort of outpatient LA-TBEA [3,6,[11][12][13][14] . Apart from two other studies with a 4-to 6-year follow-up [14,15] , this study also represents the longest follow-up of outpatient TBEA.…”

Section: Discussionmentioning

confidence: 95%

Outpatient Thermachoice Endometrial Balloon Ablation: Long-Term, Prognostic and Quality-of-Life Measures

Varma¹,

Soneja²,

Samuel³

et al. 2010

Gynecol Obstet Invest

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“…In a similar study, Bongers 4 reported 18% of the patients with complete amenorrhea at three months follow-up, 21% at six months follow-up and 22% at one year follow-up. These rates were 42%, 39%, 43% and 57% respectively for menstruation of less than four days.…”

Section: Discussionmentioning

confidence: 78%

Uterine balloon therapy for the treatment of menorrhagia

Agarwal

Bhargava

Chutani

et al. 2011

J Obstet Gynecol India

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Objective(s):To evaluate the effectiveness of uterine balloon therapy for the treatment of menorrhagia and to determine its prognostic factors. Method(s): Seventy five patients were treated with uterine balloon therapy with thermachoice II for intractable menorrhagia without detectable pathology and the results were statistically analyzed regarding procedure efficacy, safety, side effects and prognostic factors at follow-up periods of one month, three months, six months and 12 months. Results(s): After undergoing uterine balloon therapy, 41.30% patients attained eumenorrhea, 30.43% hypomenorrhea and 15.21% amenorrhea at the end of 12 months follow-up. Retroverted uterus, prolonged duration of menstruation, endometrial thickness of at least 9mm and uterine depth >10 cm were associated with an increased risk of treatment failure. Conclusion(s): Uterine balloon therapy is an efficient and reliable modality to treat women with intractable menorrhagia especially those who have completed their families but do not want to part with their uterus which of course is without any organic pathology.

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“…It does not require a hysteroscopy and can be performed under local anesthesia. To use TBEA, patients with DUB cannot have a long or an irregularly shaped uterine cavity because the balloon must be in direct contact with the uterine wall [6,7]. The efficacy of TBEA is linked to the morphological changes that occur in the endometrium and submucosal layers months after therapy [8,9].…”

Section: Introductionmentioning

confidence: 99%

Outcome and uterine arteries Doppler velocimetry after thermal balloon endometrial ablation in menorrhagia

Abdelazim

Belal

2013

Evidence Based Womenʼs Health Journal

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ObjectiveThis prospective study was designed to evaluate the outcome and the changes in uterine artery blood flow after thermal balloon endometrial ablation (TBEA) in cases of menorrhagia. Study design Prospective study. Patients and methods Eighty-two premenopausal women with menorrhagia were included in this study.The TBEA was carried out on cycle days 3-8. Transvaginal color Doppler measurements were obtained from the uterine arteries on both sides before ablation and repeated on the first day, 3, 6, and 12 months after TBEA. ResultsOf 82 women, 78 (95.12%) were satisfied and experienced improvement after TBEA. The end-diastolic velocity was significantly decreased 6 and 12 months after TBEA (5.0 ± 2.5 and 4.6 ± 3.0; respectively); also, the time-averaged maximum velocity was significantly decreased 6 and 12 months after TBEA (14.8 ± 3.4 and 13.9 ± 3.4, respectively). The pulsatility index was significantly increased 6 and 12 months after TBEA (1.6 ± 0.9 and 1.63 ± 0.8, respectively); also, the resistance index was significantly increased 6 and 12 months after TBEA (0.89 ± 0.2 and 0.90 ± 0.3, respectively). Conclusion TBEA induces increase in impedance of the uterine blood flow because of fibrosis in the endometrium and subendometrial layers, with a subsequent reduction in the menstrual flow.

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Prognostic Factors for the Success of Thermal Balloon Ablation in the Treatment of Menorrhagia

Cited by 14 publications

References 26 publications

Outpatient Thermachoice Endometrial Balloon Ablation: Long-Term, Prognostic and Quality-of-Life Measures

Outpatient Thermachoice Endometrial Balloon Ablation: Long-Term, Prognostic and Quality-of-Life Measures

Uterine balloon therapy for the treatment of menorrhagia

Outcome and uterine arteries Doppler velocimetry after thermal balloon endometrial ablation in menorrhagia

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