Life-table analysis of the success of thermal balloon endometrial ablation in the treatment of menorrhagia.
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.
Lok
Ingrid Hung
IH
Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. ingridlok@cuhk.edu.hk
Leung
Pui Ling
PL
Ng
Pui Shan
PS
Yuen
Pong Mo
PM
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