Endometrial ablation: Types, techniques and evidences of its usefulness. literature review

Ablación endometrial: Tipos, técnicas y evidencias de su utilidad. revisión de la literatura

Endometrial ablation was introduced as an alternative to hysterectomy in the management of menorrhagia, a very common and disabling problem, affecting the quality of life of women of reproductive age. It consists of removing or destroying the entire thickness of the endometrium, in order to achieve the oligo or amenorrhea. Two generations of techniques have been described: first-generation techniques eliminate the full thickness of the endometrium under direct visualization with electrosurgical instruments. The second generation depends on a device that is inserted into the uterine cavity and releases thermal energy to destroy the endometrium. Although they are procedures known worldwide, in our country there are few studies and the technique has not been widespread. The review of the literature about the state of the art of endometrial ablation techniques is carried out, with an explanation, indications, complications and advantages. Strategies are proposed for future studies that may be useful in the practice of gynecology services in Colombia.

1. Matteson KA, Abed H, Wheeler II TL, Sung VW, Rahn DD, Schaffer JI, Balk EM. A systematic review comparing hysterectomy with less-invasive treatments for abnormal uterine bleeding. J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):13-28.

2. Vilos GA. Hysteroscopic and nonhysteroscopic endometrial ablation. Obstet Gynecol Clin North Am. 2004 Sep; 31(3):687-704.

3. McGurgan P, O’Donovan P. Second-generation endometrial ablation–an overview. Best Pract Res Clin Obstet Gynaecol. 2007;21(6):931-45.

4. Lethaby A, Hickey M, Garry R, Penninx J. Endometrial resection/ablation techniques for heavy menstrual bleeding (review). Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001501.

5. De los Rios JF, Castañeda JD, Calle GA, Serna E, Vásquez RA, Arango AM, Flórez OJ, Mejía AM, Arango V, Palacio T. Histerectomía laparoscópica total en la unidad de endoscopia ginecológica de la Clínica del Prado, Medellín (Colombia) 2002-2008. Rev. Colomb. Obstet. Ginecol. 2009(4):320-7.

6. National Institute for Health and Clinical Excellence. Heavy menstrual bleeding. NICE clinical guideline 44. London: NICE; 2007.

7. Munro MG. Endometrial ablation: Where have we been? where are we going?. Clin Obstet Gynecol. 2006 Dec; 49(4):736-66.

8. Bhattacharya S, Middleton L, Tsourapas A, Lee A, Champaneria R, et al. Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and costeffectiveness analysis. Health Technol Assess. 2011 Apr; 15(19): iii-xvi, 1-252.

9. Kaunitz AM, Meredith S, Inki P, Kubba A, Sanchez-Ramos L. Levonorgestrel-releasing intrauterine system and endometrial ablation in heavy menstrual bleeding: a systematic review and meta-analysis. Obstet Gynecol. 2009 May;113(5):1104-16.

10. Sweet MG, Schmidt-Dalton TA, Weiss PM, Madsen KP. Evaluation and management of abnormal uterine bleeding in premenopausal women. Am Fam Physician. 2012;85(1):35-43.

11. Bhattacharya S, Cameron I, Parkin D, Abramovich D, Mollison J, Pinion S, Alexander D, Grant A, Kitchener H. A pragmatic randomised comparison of transcervical resection of the endometrium with endometrial laser ablation for the treatment of menorrhagia. Br J Obstet Gynaecol. 1997 May; 104(5):601-7.

12. Papadopoulos NP, Magos A. First-generation endometrial ablation: roller-ball vs loop vs laser. Best Pract Res Clin Obstet Gynaecol. 2007 Dec;21(6):915-29.

13. McGurgan P, O’Donovan P. Endometrial ablation. Curr Opin Obstet Gynecol. 2003 Aug; 15(4):327-32.

14. Zarek S, Sharp HT. Global endometrial ablation devices. Clin Obstet Gynecol. 2008 Mar; 51(1):167-75.

15. Garside R, Stein K, Wyatt K, Round A, Pitt M. A cost–utility analysis of microwave and thermal balloon endometrial ablation techniques for the treatment of heavy menstrual bleeding. BJOG. 2004 Oct; 111(10):1103-14.

16. Neuwirth R, Duran A, Singer A, MacDonald R, Bolduc L. The endometrial ablator: a new instrument. Obstet Gynecol. 1994 May; 83(5 Pt 1):792-6.

17. Della Badia C, Nyirjesy P, Atogho A. Endometrial ablation devices: review of a manufacturer and user facility device experience database. J Minim Invasive Gynecol. 2007 Jul-Aug; 14(4):436-41.

18. Daniels J, Middleton L, Champaneria R, Khan K, Cooper K, Mol B, Bhattacharya S. Second generation endometrial ablation techniques for heavy menstrual bleeding: network meta-analysis. BMJ. 2012 Apr 23;344: e2564.

19. Goldstuck N. Assessment of Uterine Cavity Size and Shape: A Systematic Review Addressing Relevance to Intrauterine Procedures and Events. Afr J Reprod Health. 2012 Sep; 16(3):130-9.

20. Bongers MY. Second-generation endometrial ablation treatment: Novasure. Best Pract Res Clin Obstet Gynaecol. 2007 Dec; 21(6):989-94.

21. The Practice Committee of the American Society for Reproductive Medicine. Indications and options for endometrial ablation. Fertil Steril. 2008 Nov;90(5 Suppl):S236-40.

22. Sowter M, Lethaby A, Singla A. Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding. Cochrane Database Syst Rev. 2002;(3):CD001124.

23. Paskowitz R. “Rollerball” ablation of the endometrium. J Reprod Med. 1995 May; 40(5):333-6.

24. Fresno-Alba S, DeLlera-Duarte Á, Vidal-Roncero H, Usandizaga R, DeSantiago-García J, Zapardiel I. Ablación endometrial: estudio comparativo entre la resección histeroscópica y el sistema Novasure. Ginecol Obstet Mex. 2013;81:175-9.

25. Bhattacharya S, Cameron IM, Parkin DE et al. A pragmatic randomised comparison of transcervical resection of the endometrium with endometrial laser ablation for the treatment of menorrhagia. Br J Obstet Gynaecol. 1997; 104: 601-607.

26. Munro MG. Endometrial ablation for heavy menstrual bleeding. Curr Opin Obstet Gynecol. 2005 Aug; 17(4):381-94.

27. Longinotti MK, Jacobson GF, Hung Y-Y, Learman LA. Probability of hysterectomy after endometrial ablation. Obstet Gynecol. 2008 Dec; 112(6):1214-20.

28. Amso NN. Clinical and health service implications of second generation endometrial ablation devices. Curr Opin Obstet Gynecol. 2006 Aug;18(4):457-63.

29. Matteson KA, Abed H, Wheeler II TL, Sung VW, Rahn DD, Schaffer JI, Balk EM. A systematic review comparing hysterectomy with less-invasive treatments for abnormal uterine bleeding. J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):13-28.

30. Yeasmin S, Nakayama K, Ishibashi M, Katagiri A, Iida K, Nakayama N, Aoki S, Kanaoka Y, Miyazaki K. Microwave endometrial ablation as an alternative to hysterectomy for the emergent control of uterine bleeding in patients who are poor surgical candidates. Arch Gynecol Obstet. 2009 Aug; 280(2):279-82.

31. Glasser MH. Practical Tips for Office Hysteroscopy and Second-Generation Global Endometrial Ablation. J Minim Invasive Gynecol. 2009 Jul- Aug;16(4):384-99.

32. Amso NN, Fernandez H, Vilos G, Fortin C, McFaul P, Schaffer M, Van der Heijden P, Bongers MY, Sanders B, Blanc B. Uterine endometrial thermal balloon therapy for the treatment of menorrhagia: longoterm multicentre followoup study. Hum Reprod. 2003 May; 18(5):1082-7

33. Vilos GA, Edris F. Second-generation endometrial ablation technologies: the hot liquid balloons. Best Pract Res Clin Obstet Gynaecol. 2007 Dec;21(6):947-67.

34. Varma R, Soneja H, Samuel N, Sangha E, Clark TJ, Gupta JK. Outpatient Thermachoice endometrial balloon ablation: long-term, prognostic and quality-of-life measures. Gynecol Obstet Invest. 2010;70(3):145-8.

35. Corson SL. The Hydro ThermAblator. Best Pract Res Clin Obstet Gynaecol. 2007 Dec; 21(6):979-87.

36. Hachmann-Nielsen E, Rudnicki M. Clinical outcome after hydrothermal ablation treatment of menorrhagia in patients with and without submucous myomas. J Minim Invasive Gynecol. 2012 Mar-Apr; 19(2):212-6.

37. Iglesias DA, Madani Sims S, Davis JD. The effectiveness of endometrial ablation with the Hydro ThermAblator (HTA) for abnormal uterine bleeding. Am J Obstet Gynecol. 2010 Jun; 202(6):622.e1-6.

38. Sambrook A, Cooper K, Campbell MK, Cook JA. Clinical outcomes from a randomised comparison of microwave endometrial ablation with thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding. BJOG. 2009 Jul; 116(8):1038-45.

39. Madhu CK, Nattey J, Naeem T. Second generation endometrial ablation techniques: an audit of clinical practice. Arch Gynecol Obstet. 2009 Oct;280(4):599- 602.

40. Sambrook A, Bain C, Parkin D, Cooper K. A randomised comparison of microwave endometrial ablation with transcervical resection of the endometrium: follow up at a minimum of 10 years. BJOG. 2009 Jul; 116(8):1033-7.

41. Sambrook A, Jack S, Cooper K. Outpatient microwave endometrial ablation: 5 year followoup of a randomised controlled trial without endometrial preparation versus standard day surgery with endometrial preparation. BJOG. 2010;117(4):493-6.

42. Elmardi A, Furara S, Khan F, Hamza M. NovaSure impedance controlled system for endometrial ablation: the experience of the first UK reference centre. J Obstet Gynaecol. 2009 Jul; 29(5):419-22.

43. Kalkat R, Cartmill R. NovaSure endometrial ablation under local anaesthesia in an outpatient setting: an observational study. J Obstet Gynaecol. 2011;31(2):152-5.

44. Justin W, Ibraheim M, Bagtharia S, Haloob R. Current minimal access techniques in the treatment of heavy menstrual bleeding. Obstet Gynaecol. 2007;9(4):223-32.

45. Donnez J, Polet R, Rabinovitz R, Ak M, Squifflet J, Nisolle M. Endometrial laser intra-uterine thermotherapy: the first series of 100 patients observed for 1 year. Fertil Steril. 2000; 74: 791-96.

46. Perino A, Castelli A, Cucinella G, Biondo A, Pane A, Venezia R. A randomized comparison of endometrial laser intrauterine thermotherapy and hysteroscopic endometrial resection. Fertil Steril. 2004; 82: 731-34.

47. Brown J, Blank K. Minimally Invasive endometrial ablation device complications and use outside of the manufacturers’ instructions. Obstet Gynaecol. 2012;120(4):865-70.

48. Daniels JP. The long-term outcomes of endometrial ablation in the treatment of heavy menstrual bleeding. Curr Opin Obstet Gynecol. 2013;25(4):320-6.

49. Sharp HT. Endometrial ablation: postoperative complications. Am J Obstet Gynecol. 2012 Oct; 207(4):242-7.

50. Hellier S, Berkhoudt K. A case of postablation tubal sterilization syndrome. Adv Emerg Nurs J. 2012 Jul-Sep; 34(3):204-8.