Microwave endometrial ablation: development, clinical trials and outcomes at three years

David A. Hodgson, I Feldberg, Nicholas Sharp, N. J. Cronin, Martyn J. Evans, Lynn Hirschowitz
In: BJOG: An International Journal of Obstetrics & Gynaecology · 1999 · vol. 106(7) , pp. 684–694 · doi:10.1111/j.1471-0528.1999.tb08368.x · PMID:10428525 · W2094466378
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Microwave endometrial ablation provided amenorrhea or lighter periods for over 60% of women and high satisfaction at three years, significantly improving dysmenorrhea.

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Abstract

OBJECTIVE: To describe the introduction of microwave endometrial ablation to clinical practice, and to report the outcomes three years after endometrial ablation. DESIGN: A clinical trial using prototype microwave endometrial ablation equipment. SETTING: District general hospital. POPULATION: Forty-three women with completed families and with failed medical management for menorrhagia were treated with microwave endometrial ablation between October 1994 and April 1995. MAIN OUTCOME MEASURES: A statement of perceived menstrual loss and satisfaction supported by a menstrual symptom questionnaire score. Dysmenorrhoea was graded as a measure of described severity. Treatment time. RESULTS: Forty-three women had a total of 46 treatments. Mean treatment time: n = 43, was 141 seconds (50-310). Amenorrhoea: n = 16; 37.2%. Very light periods/discharge: n = 11; 25.6%. Improved periods and woman satisfied: n = 9; 20.9%. Improved periods and woman not satisfied: n = 1; 2.3%. Overall satisfaction at three years is 83.7%. Moderate (55.8%) or severe (27.9%) dysmenorrhoea pre-operatively had improved to 11.6% and 6.8% respectively at three years. Three re-treatments and four hysterectomies will be discussed. CONCLUSIONS: Microwave endometrial ablation is a new treatment for dysfunctional uterine bleeding using the application of microwave energy to the endometrium. This results in a rapid but restricted depth of intrauterine heating avoiding hysteroscopic fluid, operative haemorrhage and earthing risks. The technique is simple to learn and perform. Women report a high level of satisfaction three years after microwave endometrial ablation.

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dysmenorrhea

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