M Harmon1, A V Kasbekar2, A Sinha3, V Andrews4. 1. University Hospital Lewisham, London, SE13 6LH, UK. 2. Aintree University Hospital, Liverpool, L9 7AL, UK. 3. University Hospital of Wales, Cardiff, CF14 4XW, UK. 4. University Hospital Lewisham, London, SE13 6LH, UK. vasanth_andrews@hotmail.com.
Abstract
BACKGROUND: Menorrhagia is a common gynaecological complaint, with significant burden to both its sufferers and health service providers. The first line of treatment is usually medical/pharmaceutical although in some cases surgery is required. There are now a number of minimally invasive surgical techniques available that ablate the uterine lining and prevent the need for the removal of the uterus. Microwave endometrial ablation (MEA) is one of these techniques, and this paper investigates the effect of the working temperature on outcome. METHODS: A retrospective case note review of women who underwent MEA between June 2000 and August 2004. All women had a hysteroscopy followed by MEA. The duration of the procedure and mean working temperature of the MEA treatment was calculated. Women were followed up 6-8 months after surgery. FINDINGS: Two hundred and eleven women underwent the procedure, with an average duration of menorrhagia of 30 months prior to the procedure. Eighty-nine percent attended follow-up, 80 % were satisfied with the procedure and 40 % were amenorrhoeic. When the procedure was performed at higher working temperature within the manufacturers guidelines women were more likely to be amenorrhoeic (78.4 vs. 77.1 °C, p = 0.014). CONCLUSION: MEA is more effective in treating menorrhagia when used at a higher operating temperature.
BACKGROUND:Menorrhagia is a common gynaecological complaint, with significant burden to both its sufferers and health service providers. The first line of treatment is usually medical/pharmaceutical although in some cases surgery is required. There are now a number of minimally invasive surgical techniques available that ablate the uterine lining and prevent the need for the removal of the uterus. Microwave endometrial ablation (MEA) is one of these techniques, and this paper investigates the effect of the working temperature on outcome. METHODS: A retrospective case note review of women who underwent MEA between June 2000 and August 2004. All women had a hysteroscopy followed by MEA. The duration of the procedure and mean working temperature of the MEA treatment was calculated. Women were followed up 6-8 months after surgery. FINDINGS: Two hundred and eleven women underwent the procedure, with an average duration of menorrhagia of 30 months prior to the procedure. Eighty-nine percent attended follow-up, 80 % were satisfied with the procedure and 40 % were amenorrhoeic. When the procedure was performed at higher working temperature within the manufacturers guidelines women were more likely to be amenorrhoeic (78.4 vs. 77.1 °C, p = 0.014). CONCLUSION:MEA is more effective in treating menorrhagia when used at a higher operating temperature.
Entities:
Keywords:
Ablation; Amenorrhea; Menorrhagia; Temperature
Authors: R Hurskainen; S Grenman; I Komi; E Kujansuu; R Luoto; M Orrainen; K Patja; J Penttinen; S Silventoinen; J Tapanainen; J Toivonen Journal: Acta Obstet Gynecol Scand Date: 2007 Impact factor: 3.636