title: Life-table analysis of the success of thermal balloon endometrial ablation in the treatment of menorrhagia.
abstract: OBJECTIVE
  To evaluate the change in intrauterine pressure during thermal balloon endometrial ablation and to identify risk factors associated with treatment failure.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  Seventy two consecutive patients with idiopathic menorrhagia refractory to medical treatment.
  
  
  METHODS
  Thermal balloon endometrial ablation under patient-controlled sedation.
  
  
  METHODS
  Change in intrauterine pressure during the treatment cycle and risk factors associated with treatment failure.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Maintaining high intrauterine pressure during the treatment cycle and correction of the retroversion may help to improve treatment success in thermal balloon endometrial ablation.
authors: Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. ingridlok@cuhk.edu.hk
authors: Ingrid Hung
authors: IH
authors: Lok
authors: Pui Ling
authors: PL
authors: Leung
authors: Pui Shan
authors: PS
authors: Ng
authors: Pong Mo
authors: PM
authors: Yuen
mesh_terms: D000328:Adult; D017115:Catheter Ablation; D004717:Endometrium; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D015993:Life Tables; D008595:Menorrhagia / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D016896:Treatment Outcome; D014599:Uterus / Q000503:physiopathology