Objective To describe the introduction of microwave endometrial ablation to
clinical practice, and to report the outcomes three years after endometria
l ablation.
Design A clinical trial using prototype microwave endometrial ablation equi
pment.
Setting District general hospital.
Population Forty-three women with completed families and with failed medica
l management for menorrhagia were treated with microwave endometrial ablati
on between October 1994 and April 1995.
Main outcome measures A statement of perceived menstrual loss and satisfact
ion supported by a menstrual symptom questionnaire score. Dysmenorrhoea was
graded as a measure of described severity. Treatment time.
Results Forty-three women had a total of 46 treatments. Mean treatment time
: n = 43, was 141 seconds (50-310). Amenorrhoea: n = 16; 37.2%. Very light
periods/discharge: It = 11; 25.6%. Improved periods and woman satisfied: n
= 9; 20.9%. Improved periods and woman not satisfied: n =1; 2.3%. Overall s
atisfaction at three years is 83.7%, Moderate (55.8%) or severe (27.9%) dys
menorrhoea preoperatively had improved to 11.6% and 6.8% respectively at th
ree years. Three re-treatments and four hysterectomies will be discussed.
Conclusions Microwave endometrial ablation is a new treatment for dysfuncti
onal uterine bleeding using the application of microwave energy to the endo
metrium. This results in a rapid but restricted depth of intrauterine heati
ng avoiding hysteroscopic fluid, operative haemorrhage and earthing risks.
The technique is simple to learn and perform. Women report a high level of
satisfaction three years after microwave endometrial ablation.