Menstrual Disorder Treatment: Therapy & Treatment Systems
Uterine Cryoblation Therapy: The FDA also recently granted marketing approval for HerOption™ Uterine Cryoblation Therapy System. The therapy system involves a slender probe attached to a cooling unit. The probe is inserted through the cervix into the uterus. The tip of the probe is brought to a very low temperature to freeze and eliminate the uterine lining responsible for the excessive bleeding. Her Option is the first FDA-approved technique that uses hypothermia to destroy the endometrium. Because the procedure can be controlled through the use of ultrasound guidance, a thorough level of ablation may be safely achieved.
The NovaSure Impedance Controlled Endometrial Ablation System is a new, FDA-approved device for the treatment of excessive menstrual bleeding (menorrhagia); the device works by ablating, or destroying, the lining of the uterus using radiofrequency energy. The procedure is performed with a handheld catheter that delivers radiofrequency energy for about 90 seconds, significantly less time than for other endometrial ablation treatments, according to Novacept, NovaSure's Palo Alto, California-based manufacturer.
Blind endometrial ablation/uterine balloon therapy: a relatively new device (marketed as ThermaChoice®) is safer than the rollerball thermal ablation procedure because your uterus is not filled with fluid during the procedure. Because no visualization is necessary, the instrument is smaller, and requires no special skill. The major drawbacks of uterine balloon therapy are that it cannot be used in many uteri (those that are larger than normal, have an abnormal shape, or contain fibroids or polyps) and that it appears to be less effective than either of the hysteroscopic techniques in experienced hands. During this procedure, a soft, flexible balloon attached to a thin probe is inserted into your vagina through the cervix and placed in your uterus. The balloon is inflated with sterile fluid and expands to fit the contours of your uterus. Then, the fluid is heated to 87 degrees Celsius. This treatment lasts for eight minutes and thermally destroys your uterine lining. Afterwards, the fluid is withdrawn, the balloon deflates, and the device is removed from your uterus through your cervix and vagina. Nothing remains in your uterus after the procedure is complete.
During this procedure, a soft, flexible balloon attached to a thin probe is inserted into your vagina through the cervix and placed in your uterus. The balloon is inflated with sterile fluid and expands to fit the contours of your uterus. Then, the fluid is heated to 87 degrees Celsius. This treatment lasts for eight minutes and thermally destroys your uterine lining. Afterwards, the fluid is withdrawn, the balloon deflates, and the device is removed from your uterus through your cervix and vagina. Nothing remains in your uterus after the procedure is complete.
You should note that the balloon therapy cannot be used if you have uterine polyps, fibroids or if your uterus is irregularly shaped (also known as septum). These conditions affect about 35 percent of all women who are treated for abnormal uterine bleeding.
Uterine balloon therapy is designed as an outpatient procedure and may be performed under local or general anesthesia. Most women take less than one day to recover. You may experience some cramping during the procedure and a watery, pink discharge for about two weeks, which are symptoms common to any ablation or D&C procedure. The procedure is recommended only for women who have completed their families, as it destroys the uterine lining and therefore, fertility. Following treatment, you must use contraception. Although thermal ablation destroys the uterine lining, there is a small chance that pregnancy could occur, which can be dangerous to both mother and fetus.
Risks associated with this technique are considered much smaller than other thermal ablation techniques. However, risks may include uterine perforation, fluid leakage from the balloon, blood loss and burning of internal structures. Thermal balloon ablation appears to have substantially less efficacy than the hysteroscopic methods (rollerball and EMR).
About 15 percent of women treated with thermal balloon actually stop having periods (called amenorrhea). With hysteroscopic endometrial ablation (rollerball), about 40 percent of women can expect to become amenorrheic. With hysteroscopic EMR, about 85 percent of women can expect amenorrhea.