[Endometrial ablation using hydrothermablator: results of a French multicenter study].
OBJECTIVE
To evaluate the reproducibility, the feasibility and the functional results of the HydroThermAblator (HTA) technique.


METHODS
This is a retrospective multicenter study in which 143 patients were enrolled in six French medical centers. Patients suffering from dysfunctional and heavy uterine bleeding were treated using the HTA technique between June 2003 and June 2005. A preoperational questionnaire describing the symptoms as well as a qualitative assessment of bleeding was filled. We report the surgical conditions as well as the per- and postoperative complications. We analyzed the level of patient's satisfaction with this technique using a postoperative questionnaire.


RESULTS
The average patient's age was 48 years (37-67 years). Patients described their bleeding as being very significant in 46% of the cases, significant in 36%, normal but postmenopausal in 11% of the cases and unknown in 7% of the cases. Previous treatment for bleeding was prescribed in 42.4% of cases. Forty-two decimal four percent of the patients had myomas on preoperative ultrasound examinations. Four minor operative complications were encountered. Thirteen patients had postoperative complications, most of which were described as pelvic pain. Mean postoperative follow-up time was nine months. There were 72.7% of the patients who were satisfied with the procedure. Forty-four percent of the patients were amenorrheic, 37% were oligomenorrheic and 13% were eumenorrheic. Seven patients underwent hysterectomy. The indication for hysterectomy in half of these patients was persistent menorrhagias.


CONCLUSIONS
The hydrothermablator is a simple and efficient endometrial ablation technique for patients suffering from menometrorrhagias. This technique can be used in patients with uterine myomas and irregular uterine cavity. Hydrothermablation must be carried out under hysteroscopic control, which allows to assess treatment success at the end of the intervention. Histology is compulsory (with the exception of patients with metrorrhagia only), all the more so as cancer cases can remain undiscovered.
Guillot
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Service de gynécologie-obstétrique, maternité Aline-de-Crépy, hôpital Bichat-Claude-Bernard (AP-HP), 46, rue Henri-Huchard, 75018 Paris, France.
Omnes
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Yazbeck
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C
Madelenat
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P
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods* / Q000592:standards; D007889:Leiomyoma / Q000601:surgery*; D008599:Menstruation Disturbances / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*