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Evaluation of ThermaChoice uterine balloon therapy system for endometrial ablation in women with menorrhagia
August 1998, Vol. 5, No. 3 Supplement The journal of the American Association of Gynecologic Laparoscopists
underwent laparoscopic ovarian drilling. Inclusion criteria were infertility for more than 2 years, hysteroscopic and HSG evaluations of the uterine cavity, normal patent tubes, and normal seminal fluid according WHO criteria. Endocrine evaluation assessed the presence of elevated LH:FSH ratio and androgen excess. Patients were divided in two groups according to normal (between 18 and 27; group 1,20 patients) or high (>27; group 2 19) BMI. Follow-up was 1 year. No statistical differences in mean age and years of infertility were present between groups. Mean LH levels were statistically higher in women in group 2, who had higher androgen levels (NS). Fourteen patients in group 1 had spontaneous menses and spontaneous ovulation, and six conceived spontaneously. In group 2, 15 women had spontaneous menses and spontaneous ovulation, and 11 conceived spontaneously. Conclusion. Laparoscopic ovarian drilling is excellent therapy in restoring ovulation in infertile patients with PCO who failed to ovulate spontaneously or after CC therapy. Those who are overweight seem to respond particularly well to this treatment.
Measurements and Main Results. Forty qualified women were assigned to one of two treatments for endometrial thinning before undergoing uterine balloon therapy: a 3-minute suction D&C or 1 month of GnRH agonist administration. Uterine bleeding was documented at baseline and at 6 months after the procedure. Preprocedure and postprocedure evaluations were conducted by patients and physician to assess degree of bleeding. No safety issues related to the device were noted. Silicone balloon material appears to perform similarly to latex balloons. Conclusion. Women treated with GnRH agonist appeared to have a better amenorrhea rate than those undergoing D&C. In addition, both groups appear to have improved amenorrhea rate over the device without circulator. 194. Endometrial Ablation and Laparoscopic Surgery Is an Effective Alternative to Hysterectomy for Women with Menorrhagia and other Pelvic Pathology GA Vilos, GR Yeates, AD Orossos, LM Elit. University of Western Ontario, Department of Obstetrics and Gynecology, London, Ontario, Canada.
192. The Laparoscope as the Major Tool in
Hysterectomies PF Vietz, TS Ahn. Carroll County General Hospital, Westminster, Maryland.
Objective. To determine hysterectomy rates, clinical findings, and outcome after concomitant endometrial ablation and laparoscopic surgery in women with menorrhagia and additional indications for hysterectomy. Measurements and Main Results. We reviewed the charts of 166 women (age range 26-57 yrs, mean 38.2 yrs) with menorrhagia and at least one more indication for hysterectomy. In addition to menorrhagia, the most frequent complaints were chronic pelvic pain (63), dyspareunia (49), pelvic mass (33), and back pain (24). Operating time for both procedures ranged from 20 to 141 minutes (mean 56 min). Laparoscopic procedures included excision of endometriosis (73), adhesiolysis (48), adnexectomy-cystectomy (47), myomectomy-myolysis (25), uterine suspension (16), appendectomy (14), and cul-de-sac dissection (4). At 6 to 48 months of follow-up, 28 patients (17%) underwent hysterectomy for persistent pelvic pain or fibroids. Seven (4%) had repeat ablation. The most common pathologic findings after hysterectomy were leiomyomas (29%) and adenomyosis (19%). Conclusion. Concomitant laparoscopic surgery and endometrial ablation is an effective alternative to hysterectomy for women with menorrhagia and other benign pelvic pathology.
Objective. To describe our experience performing CISH as an alternative to TAH, TVH, and LAVH. Measurements and Main Results. From December 1991 through December 1997 we performed 382 hysterectomies for benign disease. Three hundred (78.5%) were CISH, 36 (9.4%) TVH, 32 (8.4%) LAVH, and 14 (3.7%) TAH. Since CISH requires only minimal instrumentation and is solely done pelviscopically, our operating times and cost are consistently below the average of traditional techniques. Conclusion. CISH has become the hysterectomy of choice for benign pelvic disease. 193. Evaluation of ThermaChoice Uterine Balloon Therapy System for Endometrial Ablation in Women with Menorrhagia GA Vilos. Department of Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada.
Objective. To assess the safety and efficacy of ThermaChoice uterine balloon therapy system that circulates fluid to treat women with menorrhagia.
$55
underwent laparoscopic ovarian drilling. Inclusion criteria were infertility for more than 2 years, hysteroscopic and HSG evaluations of the uterine cavity, normal patent tubes, and normal seminal fluid according WHO criteria. Endocrine evaluation assessed the presence of elevated LH:FSH ratio and androgen excess. Patients were divided in two groups according to normal (between 18 and 27; group 1,20 patients) or high (>27; group 2 19) BMI. Follow-up was 1 year. No statistical differences in mean age and years of infertility were present between groups. Mean LH levels were statistically higher in women in group 2, who had higher androgen levels (NS). Fourteen patients in group 1 had spontaneous menses and spontaneous ovulation, and six conceived spontaneously. In group 2, 15 women had spontaneous menses and spontaneous ovulation, and 11 conceived spontaneously. Conclusion. Laparoscopic ovarian drilling is excellent therapy in restoring ovulation in infertile patients with PCO who failed to ovulate spontaneously or after CC therapy. Those who are overweight seem to respond particularly well to this treatment.
Measurements and Main Results. Forty qualified women were assigned to one of two treatments for endometrial thinning before undergoing uterine balloon therapy: a 3-minute suction D&C or 1 month of GnRH agonist administration. Uterine bleeding was documented at baseline and at 6 months after the procedure. Preprocedure and postprocedure evaluations were conducted by patients and physician to assess degree of bleeding. No safety issues related to the device were noted. Silicone balloon material appears to perform similarly to latex balloons. Conclusion. Women treated with GnRH agonist appeared to have a better amenorrhea rate than those undergoing D&C. In addition, both groups appear to have improved amenorrhea rate over the device without circulator. 194. Endometrial Ablation and Laparoscopic Surgery Is an Effective Alternative to Hysterectomy for Women with Menorrhagia and other Pelvic Pathology GA Vilos, GR Yeates, AD Orossos, LM Elit. University of Western Ontario, Department of Obstetrics and Gynecology, London, Ontario, Canada.
192. The Laparoscope as the Major Tool in
Hysterectomies PF Vietz, TS Ahn. Carroll County General Hospital, Westminster, Maryland.
Objective. To determine hysterectomy rates, clinical findings, and outcome after concomitant endometrial ablation and laparoscopic surgery in women with menorrhagia and additional indications for hysterectomy. Measurements and Main Results. We reviewed the charts of 166 women (age range 26-57 yrs, mean 38.2 yrs) with menorrhagia and at least one more indication for hysterectomy. In addition to menorrhagia, the most frequent complaints were chronic pelvic pain (63), dyspareunia (49), pelvic mass (33), and back pain (24). Operating time for both procedures ranged from 20 to 141 minutes (mean 56 min). Laparoscopic procedures included excision of endometriosis (73), adhesiolysis (48), adnexectomy-cystectomy (47), myomectomy-myolysis (25), uterine suspension (16), appendectomy (14), and cul-de-sac dissection (4). At 6 to 48 months of follow-up, 28 patients (17%) underwent hysterectomy for persistent pelvic pain or fibroids. Seven (4%) had repeat ablation. The most common pathologic findings after hysterectomy were leiomyomas (29%) and adenomyosis (19%). Conclusion. Concomitant laparoscopic surgery and endometrial ablation is an effective alternative to hysterectomy for women with menorrhagia and other benign pelvic pathology.
Objective. To describe our experience performing CISH as an alternative to TAH, TVH, and LAVH. Measurements and Main Results. From December 1991 through December 1997 we performed 382 hysterectomies for benign disease. Three hundred (78.5%) were CISH, 36 (9.4%) TVH, 32 (8.4%) LAVH, and 14 (3.7%) TAH. Since CISH requires only minimal instrumentation and is solely done pelviscopically, our operating times and cost are consistently below the average of traditional techniques. Conclusion. CISH has become the hysterectomy of choice for benign pelvic disease. 193. Evaluation of ThermaChoice Uterine Balloon Therapy System for Endometrial Ablation in Women with Menorrhagia GA Vilos. Department of Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada.
Objective. To assess the safety and efficacy of ThermaChoice uterine balloon therapy system that circulates fluid to treat women with menorrhagia.
$55