Second generation endometrial ablation techniques: an audit of clinical practice

Objective(s)  To audit the practice and effectiveness of second generation endometrial ablation techniques (microwave and thermal balloon ablation). Design and methods  An audit of microwave and balloon endometrial ablation procedures was completed and performed during a 2-year period, in two district hospitals of Calderdale and Huddersfield NHS Trust, UK. Patients were followed up with for a maximum of 1 year postoperatively, or were referred again from their GPs, with symptoms. A questionnaire was also completed to evaluate patient satisfaction. Results  About 136 and 59 women underwent balloon and microwave endometrial ablation, respectively (Total = 195), for heavy periods. By the end of year 1, 16% of patients were amenorrhoeic and 60% had lighter periods. About 15% of women did not have any relief of symptoms and needed a hysterectomy by 3 years. There were no statistically significant differences in the endometrial ablation techniques. There was no significant effect of age, body mass index, utero-cervical length, or the ablation technique on the results or the hysterectomy rates. A satisfaction survey showed that 75% of women felt better after the procedure and would recommend it to a close friend. Conclusions  Second generation ablation techniques are safe and effective methods of treating dysfunctional uterine bleeding, and are easy to use. They have reduced the incidence of hysterectomies and also have financial implications for healthcare providers.