Thermal Balloon and Rollerball Ablation to Treat Menorrhagia: A Multicenter Comparison

Meyer, William R.; Walsh, Brian W.; Grainger, David A.; Peacock, Lisa M.; Loffer, Franklin D.; Steege, John F.

doi:10.1016/s0029-7844(98)00141-0

Cited by 196 publications

(144 citation statements)

References 14 publications

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“…Examples of second-generation ablative techniques are fluid-filled thermal balloon EA (TBEA), radiofrequency (thermoregulated) balloon endometrial ablation, hydrothermal EA, 3D bipolar radiofrequency EA, microwave endometrial ablation (MEA), diode laser hyperthermy, cryoablation and photodynamic therapy. The most common techniques in the UK are TBEA Very common (> 1 in 10) Common (> 1 in 100, < 1 in 10) Uncommon (> 1 in 1000, < 1 in 100) [51][52][53] and MEA, 54,55 while the NovaSure  (Hologic Inc., Bedford, MA, USA) device 56 is becoming more widely used.…”

Section: Endometrial Ablationmentioning

confidence: 99%

“…One study compared hysterectomy 93 with Mirena. Fourteen studies compared first-generation EA techniques with those of second generation 53,54,56,79,[94][95][96][97][98][99][100][101][102][103] and eight studies compared Mirena with EA, three of which were first generation 80,104,105 and five second generation.…”

Section: Trials and Patientsmentioning

confidence: 99%

“…Overall, we received some IPD from 65% (2814/4305) of women involved in the trials, although only eight studies were able to provide all requested variables. 41,42,53,94,95,99,102,109 The remaining studies had some missing information, with limited details on patient follow-up covering subsequent operations (e.g. hysterectomy following Mirena).…”

Section: Trials and Patientsmentioning

confidence: 99%

“…For four studies that reported non-ITT analysis, 53,95,99,107 ITT analyses were undertaken using the available IPD, although it was not always clear if protocol-deviant patients were followed up correctly in these cases. Small sample sizes often lacked a sensible justification, especially in studies involving Mirena.…”

Section: Study Qualitymentioning

confidence: 99%

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Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis

Bhattacharya

Middleton²,

Tsourapas³

et al. 2011

Health Technol Assess

100

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of project...

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Section: Endometrial Ablationmentioning

confidence: 99%

Section: Trials and Patientsmentioning

confidence: 99%

Section: Trials and Patientsmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

See 2 more Smart Citations

Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis

Bhattacharya

Middleton²,

Tsourapas³

et al. 2011

Health Technol Assess

100

View full text Add to dashboard Cite

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“…There is no evidence that prophylaxis with antibiotics reduces the frequency of post-operative infections in hysteroscopic surgery, including endometrial ablation 13 . As far as we are aware, the published literature on thermal endometrial ablation by balloon does not recommend prophylactic antibiotics 3,6,8,9 .…”

Section: Discussionmentioning

confidence: 98%

Group A streptococcus septicaemia after thermal ablation of the endometrium for menorrhagia

Kessler¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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Case reportA 38 year old woman had a three-year history of menorrhagia. Her periods were regular. A copper intrauterine contraceptive device had been removed in the past because of menorrhagia and she had subsequently been sterilised. Previously, she had had a Bartholin's abscess and had been treated for cervicitis with laser vaporisation on three occasions, the last time being in 1998. She had four uncomplicated full term normal deliveries. As a child, she had meningitis and her only medication was beta mimetics to treat asthma.For several years, she had been anaemic and had been treated with iron tablets and tranexamic acid. This treatment did not reduce the menorrhagia and her general practitioner referred her to the hospital. Gynaecological examination was normal. Vaginal ultrasound revealed a uterus of normal size without fibroids and normal ovaries. Endometrial aspiration was performed and histological examinations showed secretory endometrium. Treatment was discussed and the options considered were the levonorgestrel intrauterine system and thermal ablation of the endometrium. She elected thermal ablation. The procedure was carried out five months after her first out patient appointment.Before the endometrial ablation, the vagina was cleaned with 0.1% chlorhexidine solution and 20 ml of 0.25% bupivacaine was given as a paracervical block. The cervix was dilated to 5 mm with Hegar dilators and the uterine cavity was noted to be 8 cm long. The ablation system (Thermachoice, Fa. Gynecare, Menlo Park, California, USA) was prepared and inserted into the uterine cavity in the standard manner. The ablation cycle was carried out without any problems and the woman was discharged 20 hours after the procedure.Thirty hours after the endometrial ablation, she experienced lower abdominal pain and fever. Six hours later, she was readmitted to hospital. The concentration of C reactive protein in her blood was 84 mg/ml (normal range <5 mg/ml), her platelet count was 87 Â 10 9 /L (normal range 150 -450 Â 10 9 /L) and her white cell count was 3.4 Â 10 9 /L (normal range 3.5-10 Â 10 9 /L). A clinical diagnosis of pelvic infection was made and intravenous cefuroxime and metronidazole was started. During the following hours, she deteriorated with intense abdominal pain and circulatory collapse, suggesting severe septicaemia. A laparotomy was carried out five hours after her re-admission. Inspection of the abdominal cavity revealed bilaterally necrotic tubes and ovaries and a discolouration of the fundus of the uterus. A total hysterectomy and bilateral salphingo-oophorectomy was performed and all necrotic tissue was removed. A cystoscopy was carried out and ureteric stents were inserted bilaterally. The bladder mucosa was found to be haemorrhagic and discoloured in places. The abdomen was closed.Material from the left fallopian tube and the serosa of the uterus grew group A streptococcus, sensitive to the antibiotics being prescribed. Histopathological examination showed necrosis of the endometrium and the submucosal myometriu...

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Endometrial destruction techniques for heavy menstrual bleeding

Lethaby¹,

Hickey

Garry³

2005

Cochrane Database of Systematic Reviews

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Thermal Balloon and Rollerball Ablation to Treat Menorrhagia: A Multicenter Comparison

Abstract: In the treatment of dysfunctional uterine bleeding, uterine balloon therapy is as efficacious as hysteroscopic rollerball ablation and may be safer.

Cited by 196 publications

References 14 publications

Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis

Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis

Group A streptococcus septicaemia after thermal ablation of the endometrium for menorrhagia

Endometrial destruction techniques for heavy menstrual bleeding

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