Hydrothermal Ablation

Published Date: 19th July 2016

Publication Authors: Myagerimath R,

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Introduction 

Heavy menstrual bleeding (HMB) has major impact on a woman’s quality of life. Interventions should aim to improve this rather than focusing on menstrual blood loss. Up to 60% of women with HMB undergo hysterectomy within 5 years of referral to a gynaecologist. Several ablative techniques have been developed to avoid hysterectomy. We present an audit result of Hydrothermal Ablation (HTA) procedure over a period of 10 years in a district general hospital.

Audit Methods 

A retrospective review of cases performed between 2002 and 2012. One hundred and twenty-four cases were identified from theatre diary. Surgical outcome and patients views analysed based on discharge questionnaires completed by patients on discharge at 24 months. Questionnaires focussed on women’s views of efficacy of treatment, improvement of menstruation, satisfaction, quality of life and willingness to recommend treatment to other women.

Results 

Seventy-four percent of women had amenorrhoea or oligomenorrhoea, 20% had regular but light periods, 2% had regular heavy periods (previously irregular periods). Four percent had no change in their menstrual pattern while 1.6% of women underwent hysterectomy. Results of questionnaire responses showed 77% of women experienced good to excellent quality of life, 19% were satisfied with improvement and 4% noticed no change in quality of life. Ninety-four percent women indicated they would recommend the procedure to others while 4% said

they would not and 2% were unsure. 

Discussion 

HTA is a second-generation ablative procedure with inbuilt safety mechanism to detect perforation, false passage and fluid leakage. Its main use is in situations where other ablative procedures are contraindicated such as, uterine irregularity, endometrial polyps and sub-mucosal fibroids. Second generation ablative procedures are easier to use, more effective and could be performed under local anaesthesia.

Conclusion 

HTA is safe, reliable, effective, and easy to use. Our results indicate great potential of HTA in keeping with other studies. Larger number of cases is required for more conclusive evidence. 

Myagerimath, R; Kayani, S; Nwosu, EC. (2013).  Ten years experience of hydrothermal ablation (HTA) in a district general hospital . BJOG: An International Journal of Obstetrics and Gynaecology. 120 (Supplement S1), 383

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