THERMAL BALLOON ENDOMETRIAL ABLATION - SAFETY ASPECTS EVALUATED BY SEROSAL TEMPERATURE, LIGHT-MICROSCOPY AND ELECTRON-MICROSCOPY

Thermal balloon endometrial ablation is a new method for treating meno rrhagia. The technique appears to be less difficult compared to standa rd hysteroscopic ablation techniques and to be significantly safer. Th e influence into the uterine wall of the thermal balloon ablation proc edure was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometriu m and the serosa. Study design: Temperatures were measured at the uter ine serosal surface during thermal balloon endometrial ablation for 8- 16 min in eight patients. After subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. Results: The highest temperature measured on the uterine s erosa was 39.1 degrees C. Coagulation of the myometrium adjacent to th e endometrium could be demonstrated by light microscopy in all patient s, with a maximum depth of 11.5 mm. By electron microscopy no influenc e of heat could be demonstrated beyond 15 mm from the endometrial surf ace. Conclusion: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myo metrium is only coagulated to a depth where full thickness necrosis or injury is unlikely. (C) 1998 Elsevier Science Ireland Ltd.