PRELIMINARY CLINICAL-EXPERIENCE WITH A THERMAL BALLOON ENDOMETRIAL ABLATION METHOD TO TREAT MENORRHAGIA

Objective: To evaluate the clinical effectiveness and safety of a ther mal balloon system to ablate the endometrium. Methods: All 18 patients were candidates for hysteroscopic endometrial ablation or hysterectom y for menorrhagia and consented to a trial of the balloon technique of ablation. All procedures were done in the operating room under genera l anesthesia, except in one patient who had regional and another who h ad local anesthesia with analgesia. Follow-up of 6-34 months is report ed. Results: Fifteen subjects (83%) reported significant reduction in bleeding or amenorrhea. Two patients underwent subsequent hysterectomy and one a follow-up hysteroscopic examination with biopsy. Histology in these three cases showed areas of scar as well as areas of normal e ndometrial histology. In one uterus, the entire cavity and the endomet rium were normal. The others had endometrial bands of scar and some co ntraction of the cavity. Conclusions: Based on follow-up results, the frequency of successful reduction of bleeding and/or amenorrhea in thi s small series is comparable to hysteroscopic methods of endometrial a blation. There were no complications. A larger trial is warranted to c ompare this method to hysteroscopic endometrial ablation.