The Obstetrician & Gynaecologist 2007;9:4:223-232
doi: 10.1576/toag.9.4.223.27352
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
Current minimal access techniques in the treatment of heavy menstrual bleeding
Winston Justin, MRCOG DGO, Clinical Fellow in Reproductive Medicine1,
Mofid Ibraheim, MRCOG DFFP, Locum Consultant in Obstetrics and Gynaecology2,
Seema Bagtharia, MRCOG DFFP, Clincal Fellow in Obstetrics and Gynaecology3 and
Rahim Haloob, FRCOG, Consultant Obstetrician and Gynaecologist4
1. The Centre for Reproductive Medicine, St Bartholomew's Hospital, 2nd Floor, Kenton and Lucas Wing, Little Britain, London EC1A 7BE, UK
2. Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate HG2 7SX
3. Southend Hospital NHS Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY
4. Basildon University Hospital, Nethermayne, Basildon SS16 5NL, UK Email: rhaloob{at}googlemail.com (corresponding author)
Key content:
- Heavy menstrual bleeding remains a major problem for some women.
- Hysterectomy is the leading treatment for this condition but it is recognised to have some serious complications.
- First-generation endometrial ablation techniques have a steep learning curve and are carried out under hysteroscopic visualisation.
- Second-generation techniques are simpler and have lower complication rates, lower analgesia requirements and potential for outpatient use.
- Individual assessment is important in deciding the route and method of treatment for heavy menstrual bleeding, taking clinical factors into consideration.
Learning objectives:
- To know about the various options currently available for endometrial ablation.
- To learn about the clinical application, advantages and limitations of various methods of endometrial ablation.
- To be able to make an informed choice when deciding which modality to use.
Ethical issues:
- Intense competition will continue to drive device manufacturers to make claims of effectiveness based on poor-quality evidence. All users have a responsibility to be well informed and to offer evidence-based advice to women.
Please cite this article as: Justin W, Ibraheim M, Bagtharia S, Haloob R. Current minimal access techniques in the treatment of heavy menstrual bleeding. The Obstetrician & Gynaecologist 2007;9:223–232.
Keywords endometrial ablation / levonorgestrel-releasing intrauterine system / menorrhagia / uterine artery embolisation
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
