Résumé
To compare the efficacy and safety of thermal endometrial ablation with the use of Foley's catheter with hysteroscopic rollerball endometrial ablation in the treatment of dysfunctional menorrhagia. A randomized clinical prospective comparative study. Benha University Hospital. The study included eighty patients with persistent dysfunctional menorrhagia not responding to medical treatment for whom follow up data were available for 12 months and fulfilled the inclusion criteria that were enrolled in the study. The patients were randomized into two equal groups of 40 patients each. Patients in the first group were treated by thermal ablation with the use of Foley's catheter, while those of the second group were treated by hysteroscopic rollerball ablation. Preliminary pelvic sonography, hysteroscopy and endometrial biopsy were performed to exclude intrauterine pathology. The procedure was done in the early follicular phase of menstrual cycle under general anesthesia. The main outcome measures included a 12 months follow up of menstrual blood loss and any adverse events. The twelve months follow up indicated that both techniques significantly reduced menstrual blood flow. Success rates, as reflected by percent of patients who returned to normal menstrual bleeing pattern or less were comparable being 80% for thermal balloon group and 85% for the rollerball group. The procedural time was reduced significantly in the uterine thermal balloon group [p < 0.05]. Intraoperative complications occurred in three [7.5%] of the hysteroscopic rollerball group, while no intraoperative complications occurred in the thermal balloon group. Thermal endometrial ablation with the use of Foley's catheter is a safe, simple, easy, cheap and mininally invasive procedure. It is effective as hysteroscopic rollerball ablation in treatment of dysfunctional menorrhagia, however long term follow up on large number of patients is requird for further assessment