Intraoperative and postoperative lower genital tract changes after global endometrial ablation using the Hydro ThermAblator device.
OBJECTIVE
To identify any heat transfer areas in the lower genital tract during a Hydro ThermAblator (HTA) (BEI Medical Systems) procedure and to characterize the changes in the cervix that occur in the immediate weeks after an HTA treatment.


METHODS
A prospective cohort study (Canadian Task Force classification II-3).


METHODS
A university hospital in the United Kingdom.


METHODS
Twenty-five patients with menorrhagia.


METHODS
All patients underwent global endometrial ablation using the HTA device. Infrared thermal camera imaging of the lower genital tract was performed per-operatively, and colposcopic examinations of the cervix were performed at 2 and 4 weeks after the operation.


METHODS
The surface temperature rise of the cervix and vagina during a procedure.


RESULTS
Thermal temperature measurements of the lower genital tract in five patients and colposcopic examination at 2 and 4 weeks after the procedure. The maximum temperatures recorded during a procedure were those of the cervix, reaching 36.5 degrees C. Colposcopic images at 2 weeks showed that 15% of patients had a whitish discoloration of the cervix. At 4 weeks, the appearance of the cervix was normal.


CONCLUSIONS
This study shows that during an HTA treatment cycle using a bivalve speculum to visualize the cervix, no area of the lower genital tract reaches a temperature at which thermal damage may occur. A whitish change in the cervix at 2 weeks is normal, and the lower genital tract should appear normal 4 weeks after the procedure.
Farrugia
Martin
M
Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, United Kingdom. martin@farrugia.demon.co.uk
Hussain
Sarah Y
SY
D000328:Adult; D002056:Burns / Q000209:etiology / Q000473:pathology*; D002584:Cervix Uteri / Q000293:injuries* / Q000473:pathology*; D015331:Cohort Studies; D003127:Colposcopy; D004717:Endometrium / Q000473:pathology / Q000601:surgery*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects* / Q000295:instrumentation*; D020702:Hysteroscopes; D007432:Intraoperative Period; D008875:Middle Aged; D011184:Postoperative Period; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome; D014621:Vagina / Q000293:injuries / Q000473:pathology*