Exploring thermal balloon endometrial ablation with Foley's catheter: Management for heavy menstrual bleeding

探索使用弗雷氏导尿管进行热球子宫内膜消融术:治疗月经过多出血

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Abstract

BACKGROUND: Heavy menstrual bleeding is a common gynecological issue that often requires prompt treatment. Our study aimed to assess thermal balloon endometrial ablation with Foley's catheter as a viable, cost-effective, and minimally invasive procedure alternative to hysterectomy. METHODS: An experimental study was carried out on 114 married women experiencing heavy menstrual bleeding who did not wish to have further children and had either failed standard treatments or were not suitable for medical treatment. These women had a uterine size of 12 cm or less and an endometrial thickness of less than 18 mm. A 3-min balloon inflation-deflation procedure was performed. After 3 months, the effectiveness of the treatment was assessed by examining overall heavy menstrual bleeding outcomes, posttreatment transvaginal ultrasound results, number of bleeding days and pain per cycle, and scores from the Menorrhagia Outcome Questionnaire. RESULTS: The mean patient's age was 44.46 ± 4.184 years and a disease duration of 2.84 ± 1.53 years. Most patients were multiparous (86.0%) or grand multiparous (14.0%). Significant improvements were observed in endometrial thickness, Menorrhagia Outcome Questionnaire scores, pain levels, and the number of bleeding days postprocedure (p-value < 0.05). The majority of patients experienced a reduction in the pattern of irregular menstrual cycles. The procedure showed a success rate of 88.6%, with 11.4% of patients not responding. Some further interventions such as hysterectomy or repeated thermal balloon ablation were required due to complications like infection or balloon deflation. CONCLUSION: The thermal balloon endometrial ablation using Foley's catheter is an effective treatment for heavy menstrual bleeding.

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