Modified thermal balloon endometrial ablation in low resource settings: a cost-effective method using Foley's catheter

Abstract

Objective: To assess the efficacy of a modified Foley's catheter endometrial ablation in the treatment of abnormal uterine bleeding in low resource settings.

Methods: Four hundred and thirty premenopausal women with abnormal uterine bleeding were subjected to thermal balloon endometrial ablation using modified Foley's catheter. The primary outcome measure was patient satisfaction regarding menstrual blood loss. Secondary measures included improvement in quality of life scores and failure rates.

Results: Three hundred and three patients were available for evaluation at 3-year follow up. 270/303 (89.1%) reported their satisfaction as indicated by reduction in days of menstrual flow per cycle (4.2 vs. 8.8 days, p < 0.0001). There was a significant improvement in quality of life scores (p < 0.0001). The rate of failure varies according to the interval of follow up from 15.6% at 6 months to 10.9% at 3 years.

Conclusion: Modified Foley's catheter endometrial ablation is a cost effective alternative to other thermal endometrial ablation techniques in the treatment of abnormal uterine bleeding in low resource settings.