Middle East Fertility Society Journal (Jun 2012)
Endometrial thermal balloon ablation by a simple technique using Foley’s catheter with or without pre ablation endometrial curettage to treat cases with intractable menorrhagia
Abstract
Objectives: To assess the efficacy and safety of endometrial thermal ablation by a technique using Foley’s catheter to treat cases with intractable menorrhagia and to compare between results with and without pre procedure curettage. Study design: Prospective randomized controlled study. Patients and methods: Forty eight patients aged from 39 to 52 years complaining of menorrhagia not responding to treatment for at least 6 months were included in the study, pre ablation endometrial curettage was done for 24 randomly selected cases (group 1) and ablation without curettage for the other 24 cases (group 2). A latex silicon coated Foley’s catheter with 30–50 ml capacity was tested and inserted into uterine cavity then inflated by a variable volume of boiling saline as the uterine cavity permits under moderate pressure and replaced every 2 min with a new boiling saline, for 8 min duration. Then follow up for 6 months and hysteroscopic examination were done to detect endometrial scarring. Outcome measures: Patients satisfaction, menstrual outcome, hysteroscopic diagnosed scarred endometrium. Results: This study showed a satisfaction rate of 83.3%, improvement in menstrual bleeding (79.2%) and hysteroscopic diagnosed scarring of the endometrium (75%). Cases in group 1 had a significantly higher satisfaction rate (95.8%) than in group 2 (70.8%) and significantly lower incidence of persistent menorrhagia after ablation than cases in group 2 (4.2% versus 37.5%, respectively). Hysteroscopic diagnosed endometrial scarring was significantly higher in group 1 (91.7%) versus (53.8%) for group 2. Conclusion: Endometrial thermal balloon ablation by a technique using Foley’s catheter is a safe, simple, cheap and effective procedure as an alternative to hysterectomy for treatment of menorrhagia in properly selected cases. Pre ablation endometrial curettage increases the satisfaction rate and improves menstrual outcome.
Keywords
