NATIONAL HARBOR, MD. – A thermal balloon endometrial ablation provided long-lasting benefit to women with dysmenorrhea, with 86% saying the benefits lasted for up to 11 years, and 82% reporting that they needed no further treatment for the condition.
"Patient satisfaction with [the device] is high," Vinod Kumar, Ph.D., said at a meeting sponsored by the AAGL. "It appears to be an effective option for women with symptoms of heavy menstrual bleeding and a robust alternative to hysterectomy."
Dr. Kumar of the University Hospitals Birmingham, England, presented follow-up data of up to 11 years on a cohort of 192 women who responded to a mailed survey after undergoing thermal balloon endometrial ablation with the Gynecare ThermaChoice III Uterine Balloon Therapy System.
In the cohort, 18 patients were 10-11 years postprocedure; 82 were 5-10 years postprocedure; and 92 were up to 5 years postprocedure.
They were a mean of 44 years when ablation was performed. Most (77%) had a normal uterus; 15% had an intramural fibroid; 2% a submucosal fibroid of less than 3 cm; and 3%, a polyp. The findings were undisclosed for the remainder. Uterine size was more than 10 cm in 74%.
With a mean follow-up of 30 months, 56% reported amenorrhea. Flow was lighter than before the procedure in 39% of the women, and unchanged or worse in 5%. Of the 44% who still had menstrual bleeding, length of bleeding was less than 3 days in 14%, 3-5 days in 14%, 6-7 days in 9%, and more than 8 days in 7%.
Most women (86%) reported less pain or no pain at follow-up. For 9%, there was no pain change; the rest reported a worsening of pain.
The majority of women (86%) reported that the clinical benefit had been maintained over time.
No further treatment was necessary in 82% of the group. Four women received a levonorgestrel intrauterine device. Nine were using medical therapy, including hormone therapy. One woman had a repeat endometrial ablation, and 20 had hysterectomy.
Most women (86%) reported that they were either satisfied or very satisfied with the procedure.
Dr. Kumar had no financial disclosures.