ENDOMETRIAL DESTRUCTION BY THERMAL COAGULATION - EVALUATION OF A NEW FORM OF TREATMENT FOR MENORRHAGIA

Objective To report the first clinical evaluation of a new balloon end ometrial, thermal destruction system Cavaterm(TM), for outpatient trea tment of menorrhagia. Design To elucidate possible technical problems during treatment, to evaluate how the patients tolerated the treatment and to judge which patients were suitable for this form of treatment. Main outcome measures Measurements of bleeding volumes in pads and ta mpons before and after treatment were performed as well as subjective evaluation by bleeding charts. Patients also estimated their degree of satisfaction. Setting Gynaecology department at a university hospital . Subjects 36 patients under 52 years of age with menorrhagia, without suspicion of intracavitary pathology including malignancy. Results No procedure-related complications occurred. The patients tolerated the treatment well. There was a significant reduction in measured bleeding volumes in pads and tampons, collected during one menstruation, 2-7 m onths after treatment compared with measurements before treatment. Fou r patients subsequently underwent hysterectomy and should not have bee n included in the study (two with pedunculated myoma and one with a se ptum; the fourth showed premalignant endometrial changes in the curett age preceding the treatment). At 18-28-month follow up, 29 of the suit able patients (91%) reported a significant reduction in bleeding and a nother three patients reported reduced but still profuse bleeding comp ared with pretreatment; 88% (28/32) rated the treatment results as exc ellent, and a further 9% (3/32) as good. Conclusions We found the Cava term(TM) system for endometrial destruction to be safe, efficient and easy to use.