Human Reproduction, Vol. 18, No. 5, 1082-1087,
May 2003
© 2003 European Society of Human Reproduction and Embryology
Uterine endometrial thermal balloon therapy for the treatment of menorrhagia: long-term multicentre follow-up study
1 Department of Obstetrics and Gynaecology, University of Wales College of Medicine and the University Hospital of Wales, Cardiff CF14 4XN, UK, 2 H. A. Béclère, Clamart, France, 3 St Joseph’s Health Centre, London, Canada, 4 Clin Méd. Chateauguay, Canada, 5 Belfast City Hospital, Belfast, UK, 6 University Clinic Obstetrics and Gynaecology, Graz, Austria, 7 Twenteborg H., Almelo, The Netherlands, 8 St Joseph’s Hospital, Veldhoven, The Netherlands, 9 University of British Columbia, Vancouver, Canada and 10 Hôpital Conception, Marseilles, France
11 To whom correspondence should be addressed. e-mail: amsonn{at}cardiff.ac.uk
BACKGROUND: Initial reports from observational and randomized trials of uterine endometrial thermal balloon therapy (UBT) suggested good results as judged by return to eumenorrhoea or less and patient satisfaction. Long-term follow-up data remained limited by the small numbers of patients and duration of follow-up. We present long-term (4–6 years) follow-up data from a cohort of women previously treated with UBT for menorrhagia. METHODS: Of the 260 questionnaires sent to women eligible for long-term follow-up from 10 centres, 188 (72%) replies were received. The primary outcome measure was avoidance of hysterectomy. RESULTS: In women who responded to the questionnaire, 25 had undergone hysterectomy and 21 had had repeat ablation. At 4–6 years after UBT, the probability of avoiding hysterectomy was 86% of all women, and of avoiding re-ablation was 88% of non-hysterectomized women. Overall, the probability of avoiding any surgery was 75%. Women with an axial or retroverted uterus were at greater risk of hysterectomy or re-ablation. Among the participants, 47% of the non-hysterectomized women were amenorrhoeic, 30% were hypomenorrhoeic, 13.6% were eumenorrhoeic and 8.5% had heavy periods. CONCLUSIONS: This is the first long-term follow-up report of a second-generation endometrial ablation procedure and confirms our initial experience. The high rate of hysterectomy avoidance over 5 years or more is very encouraging for this technology.
Key words: endometrial thermal balloon therapy/hysterectomy/long-term follow-up/menorrhagia/UBT
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