In-office endometrial ablation and clinical correlation of reduced menstrual blood loss and effects on dysmenorrhea and premenstrual symptomatology.

OBJECTIVE: To evaluate in-office Thermachoice III endometrial ablation on subsequent dysmenorrhea and premenstrual mood symptoms in relation to decreased menstrual blood loss. STUDY DESIGN: The study conducted was in a prospective cohort single group. Ablations were performed on 148 patients under parametrial block using dilute mepivacaine and oral anxiolysis for a diagnosis of menorrhagia. The primary endpoint was eumenorrhea or less, with secondary endpoints of dysmenorrhea reduction and premenstrual symptom alleviation. Patients were evaluated at 3 and 6 months postprocedure. Of 148 patients, 134 (90.5%) complied with follow-up. RESULTS: At 3 months, 52% were amenorrheic; 48% reporting hypomenorrhea. Results persisted at 6 months, with 50% and 48%, respectfully. Of 134 patients, 3 were considered nonresponders at 6 months. Mean hemoglobin values increased for all groups at each time endpoint. Of 115 patients, 79 reported baseline dysmenorrhea, with improvement in visual analog scale findings at both 3 and 6 months (p<0.005). Premenstrual mood symptoms of agitation, irritability and depression also improved at both 3 and 6 months. CONCLUSION: In-office Thermachoice III endometrial ablation results in decreased dysmenorrhea and improved mood in relation to decreased menstrual blood loss.

In-office endometrial ablation using a third-generation uterine balloon therapy system: 12-month prospective follow-up on menstrual patterns and dysmenorrhea impact.

OBJECTIVE: To evaluate the efficiency of in-office Thermachoice III (Ethicon, Somerville, New Jersey) endometrial ablations in resolving menstrual abnormalities as well as dysmenorrhea at 12 months after the procedure. STUDY DESIGN: This was a prospective, single arm, cohort study of women from an inner city, community based, physician group medical/ surgical clinic. Diagnostic hysteroscopy, dilation and curettage, and Thermachoice III endometrial ablation were performed under local analgesia. RESULTS: At baseline, N = 148. At 12 months, 23 patients were lost to follow-up, leaving 125 for the evaluable cohort. The largest resulting patient category was amenorrhea, with 66.4% (83 of 125 evaluable), followed by hypomenorrhea at 31% (39 of 125 evaluable). Three patients (2.4%) were considered clinical failures. These 3 patients initially were designated as having hypomenorrhea at 3 months. Dysmenorrhea reduction was statistically significant (p < 0.05) at 6 months and 12 months as compared to baseline. CONCLUSION: At 1 year after the procedure, the efficiency of in-office Thermachoice III was observed, with high amenorrhea rates as well as persistently decreased dysmenorrhea.