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CARS Archives


Thermal Balloons for Endometrial Ablation
Title: Uterine thermal balloon therapy under local anesthesia for the treatment of menorrhagia
Author:H. Hernandez et al.
Address:Clamart, France
Source:Human Reproduction 12: 2511-2514 (November) 1997
Summary:Balloon ablation therapy for menorrhagia was introduced in 1994 and it offered an opportunity to reduce the risks associated with hysteroscopic surgery. It is estimated that in over 1800 balloon ablations performed, all have used general anesthesia and therefore have the inherent risk associated with general anesthesia. This study investigates balloon ablation for the application of an office procedure under local anesthesia. The 18 participants in this study were chosen for their dysfunctional bleeding with an absence of organic lesions of the uterine cavity, adequate relaxation pain tolerance during physical examination, and the desire to avoid a general anesthetic. In preparation for the procedure the following medications were used: paracervical block with dilute 1% lignocaine HCL with epinephrine 1:200,000; 100 mg of oral ketoprofen (16 patients) and all 18 patients received 1 g paracetamol I.V.. This drug regimen was used to alleviate anxiety, pain, and/or cramping during the procedure. Median follow up was 13.9 months. No complications from the procedure occurred. A pain scale assessment (from 1-10) was initiated by the surgeon during and following the procedure. The mean for this pain scale was 3.8=1.3 and was self reported by the patients. Success was defined as amenorrhea, hypomenorrhea, or eumenorrhea. All patients experienced a significant decrease in menstrual flow, duration and pad count. The authors suggest that thermal balloon endometrial ablation is well tolerated under local anesthesia and appears to have application as an office based procedure.
Comment: A prediction is that this is a procedure with which all gynecologists will become familiar within the next year or two. Having seen the device work I am very impressed.

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