Life-table analysis of the success of thermal balloon endometrial ablation in the treatment of menorrhagia

• Published in: Fertility and sterility Vol. 80; no. 5; pp. 1255 - 1259
• Main Authors: Lok, Ingrid Hung, Leung, Pui Ling, Ng, Pui Shan, Yuen, Pong Mo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2003; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Catheter Ablation; Endometrium; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Hot Temperature - therapeutic use; Humans; Intrauterine pressure; Life Tables; life-table analysis; Medical sciences; menorrhagia; Menorrhagia - physiopathology; Menorrhagia - therapy; Middle Aged; Non tumoral diseases; Pressure; Prospective Studies; thermal balloon ablation; treatment failure; Treatment Outcome; Uterus - physiopathology; Intrauterine pressure; thermal balloon ablation; life-table analysis; menorrhagia; treatment failure; Human; Menstruation disorders; Intrauterus pressure; Ablation; Hemorrhage; Menorrhagia; Female genital diseases; Treatment; Surgery; Risk factor; Uterine diseases; Female; Life table
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(03)01176-2

To evaluate the change in intrauterine pressure during thermal balloon endometrial ablation and to identify risk factors associated with treatment failure. Prospective observational study. University-affiliated teaching hospital. Seventy two consecutive patients with idiopathic menorrhagia refractory to medical treatment. Thermal balloon endometrial ablation under patient-controlled sedation. Change in intrauterine pressure during the treatment cycle and risk factors associated with treatment failure. A spontaneous decrease in intrauterine pressure occurred in most patients (93%). The mean (±SD) decrease was 34.1 ± 14.9 mm Hg, or 19.5% ± 9.1%. The treatment failed in 10 patients (13.9%), and the mean end pressure was significantly lower in this group (131.1 ± 14.1 mm Hg vs. 145.1 ± 18.0 mm Hg; P=.02). The chance of success of treatment was significantly lower when the end pressure was <140 mm Hg (odds ratio, 0.42 [95% CI, 0.27 to 0.68]; P=.01), the intrauterine volume was >10 mL (odds ratio, 0.43 [95% CI, 0.22 to 0.83]; P=.058) and the uterus was retroverted (odds ratio, 0.36 [95% CI, 0.20 to 0.65]; P=.008). Maintaining high intrauterine pressure during the treatment cycle and correction of the retroversion may help to improve treatment success in thermal balloon endometrial ablation.