Endometrial balloon ablation under local analgesia and intravenous sedation.
We report a series of women (n = 16) with menorrhagia undergoing endometrial balloon ablation under local analgesia with light sedation. Ten women had significant, coexistent medical problems. The median duration of the procedure was 8.6 minutes (range 8.47-9.5 minutes). Postoperative assessment included pain scores assessed by linear analogue scale; requirement for opiate analgesia; length of postoperative stay and patient satisfaction with the procedure. The minimum postoperative follow-up was 6 months. The procedure was well-tolerated and in 80% of cases either no postoperative analgesia or simple analgesia only was required. Two women were admitted overnight, 1 for social reasons and the other for pain control. Three women ages 44, 54 and 55 years were amenorrhoeic at 6 months; 8 women were still menstruating but satisfied with the outcome and 5 women are seeking further treatment for menorrhagia. While the longer-term efficacy of the procedure remains to be established these results indicate that endometrial balloon ablation under local analgesia and light sedation, a simple and acceptable technique, may be a suitable alternative to more difficult procedures such as rollerball ablation. This is most likely to be the case in appropriately selected women who are willing to accept a reduction in menstrual flow rather than amenorrhoea as the treatment outcome. The main disadvantage of balloon ablation is the cost of the disposable balloons and the need for a dedicated electrosurgical unit.
Duggan
P M
PM
Department of Obstetrics and Gynaecology, University of Adelaide, South Australia.
Dodd
J
J
D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D017115:Catheter Ablation / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000523:psychology; D002404:Catheterization / Q000009:adverse effects / Q000191:economics / Q000379:methods* / Q000523:psychology; D016292:Procedural Sedation / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D017060:Patient Satisfaction; D016896:Treatment Outcome