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

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.