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Title:Thermal balloon ablation versus endometrial resection for the treatment of abnormal uterine bleeding
Author: A. Gervaise, et al.
Address: Bourg-La-Reine, France
Source:Human Reproduction 14: 2743-2747 (November) 1999
Summary: This study was conducted to compare the clinical efficiency and safety of a thermal uterine balloon system with hysteroscopic endometrial resection in the treatment of dysfunctional uterine bleeding in 147 women. From Nov. 1994 - April 1998, 73 women were enrolled in a prospective study of a thermal uterine balloon system. The control group was chosen from analysis of the records of patients undergoing resection and treated during the same period by endometrial ablation for abnormal uterine bleeding. Inclusion in the study required that women be > 40 years of age, with the exception of 2 patients in each group who had a serious medical contraindication for pregnancy in addition to menorrhagia. The indication for treatment in both groups was excessive menstrual blood loss. The premenopausal women had either unsuccessful medical therapy with progestins or were unwilling or unable to continue with medical treatment. The post-menopausal patients were not willing to discontinue HRT. Researchers found the operative time to be reduced significantly with the uterine balloon technique. There were no intra-operative complications in either group and postoperative morbidities were not statistically different. Multivariate analysis noted 2 prior factors associated with failures: retroverted uterus with thermal balloon ablation and age less than 43 years with endometrial resection. The overall success rate was not significantly different among the two groups, making uterine balloon ablation appear to be as effective as endometrial resection. The former is much easier to perform, making the technique readily reproducible, especially by those with limited expertise in hysteroscopic surgery, and thus more widely applicable and safer.