Lf. Andersen et al., THERMAL BALLOON ENDOMETRIAL ABLATION - SAFETY ASPECTS EVALUATED BY SEROSAL TEMPERATURE, LIGHT-MICROSCOPY AND ELECTRON-MICROSCOPY, European journal of obstetrics, gynecology, and reproductive biology, 79(1), 1998, pp. 63-68
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.