Hysteroscopic appearance of the endometrial cavity following thermal balloon endometrial ablation

OBJECTIVE: To assess the appearance of the endometrial cavity after thermal balloon endometrial ablation. DESIGN: Observational study. SETTING: University teaching hospital. PATIENT(S): Twenty-two women who had undergone thermal balloon endometrial ablation and who were followed up for at least 6 months. INTERVENTION(S): Outpatient diagnostic hysteroscopy. MAIN OUTCOME MEASURE(S): Appearance of the endometrial cavity and presence of intrauterine adhesions on hysteroscopy. RESULT(S): Postablation intrauterine adhesions were found in eight women (36.4%); six had focal adhesions in the fundal area and two had complete obliteration of the cavity. Of these eight women, three had spotting during menstruation, three had hypomenorrhea, one had eumenorrhea, and one had amenorrhea. The uterine cavity was fibrotic in four (18%) women; all reported spotting during menstruation. Ten women had a normal uterine cavity; eight had hypomenorrhea, one had spotting, and one had eumenorrhea. CONCLUSION(S): The hysteroscopic appearance of the uterine cavity after thermal balloon endometrial ablation varies considerably. Menstrual outcome is associated with postablation appearance.