Abstract
Background. Excessive menstrual bleeding, menorrhagia, is a common gynecological problem in women of reproductive age. Since 1994, thermal balloon ablation has become the treatment of choice for women with menorrhagia. The aim of this study was to evaluate the short- and long-term results of thermal balloon ablation for the treatment of menorrhagia in an outpatient setting. Methods. Fifty-six women with menorrhagia had undergone a balloon ablation in an outpatient setting at the Gynecological Departments at Karolinska University Hospital, Huddinge. At follow-up, all of the women were requested to complete a questionnaire concerning bleeding patterns, the degree of dysmenorrhea, side effects, or a need for further therapy after balloon ablation. Results. Thermal balloon ablation was successfully completed in 54 (97%) women. The two unsuccessful procedures consisted of one case, in which the woman had an allergic reaction to a paracervical block, and another case in which the balloon catheter could not be inserted into the uterine cavity. In three cases, short-term complications occurred: an allergic reaction to a paracervical block, endometritis, and abdominal cramps. Completed outcome questionnaires were submitted by 42 (75%) of the women. The mean follow-up period was 31 months. A reduction of menorrhagia was experienced by 34 (81%) of the women. One woman had undergone a hysterectomy and three had a hysteroscopical endometrial resection within two years after the ablation due to persistent menorrhagia. Conclusion. Thermal endometrial ablation is a safe and effective treatment for menorrhagia and is feasible in an outpatient setting.