title: Outpatient Thermachoice endometrial balloon ablation: long-term, prognostic and quality-of-life measures.
abstract: OBJECTIVE
  To evaluate short- and long-term treatment outcomes of outpatient local anaesthetic thermal balloon endometrial ablation (LA-TBEA) and identify any prognostic factors.
  
  
  METHODS
  Prospective observational study in a UK teaching hospital involving 102 menorrhagic women undergoing LA-TBEA between 2001 and 2005. Women underwent either Gynecare® Thermachoice I (n = 51) or Thermachoice III (n = 51) TBEA performed in the outpatient setting under local anaesthesia without conscious sedation. The main outcome measures were: treatment completion, pain and analgesia, duration of stay (from admission to discharge), duration of follow-up, primary treatment success and nature of any secondary treatment, menstrual symptoms and amenorrhoea, patient satisfaction, and quality of life.
  
  
  RESULTS
  TBEA was completed in 97% of women. Mean duration of stay was 8.0 h (95% CI 6.6-9.3). Mean follow-up was 30 months (95% CI 26-32). Secondary treatment with the levonorgestrel intrauterine system, repeat TBEA or hysterectomy occurred in 19/102 (19%). Overall, 50% of surgical re-interventions occurred by 19 months. There were high rates of amenorrhoea (29%) and treatment satisfaction (76%). Higher mean intrauterine ablation pressure was associated with increased treatment satisfaction.
  
  
  CONCLUSIONS
  TBEA can be successfully performed in the outpatient setting. Higher endometrial ablation pressure may improve long-term treatment outcome.
authors.affiliation: Department of Obstetrics and Gynaecology, St. Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK. rajesh.varma @ gstt.nhs.uk
authors.forename: Rajesh
authors.initials: R
authors.lastname: Varma
authors.forename: Hemi
authors.initials: H
authors.lastname: Soneja
authors.forename: Nadia
authors.initials: N
authors.lastname: Samuel
authors.forename: Eki
authors.initials: E
authors.lastname: Sangha
authors.forename: Thomas Justin
authors.initials: TJ
authors.lastname: Clark
authors.forename: Janesh K
authors.initials: JK
authors.lastname: Gupta
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D002404:Catheterization; D055356:Endometrial Ablation Techniques / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D008595:Menorrhagia / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome