Current minimal access techniques in the treatment of heavy menstrual bleeding

Authors

  • Winston Justin MRCOG DGO,

    Clinical Fellow in Reproductive Medicine
    1. The Centre for Reproductive Medicine, St Bartholomew's Hospital, 2nd Floor, Kenton and Lucas Wing, Little Britain, London EC1A 7BE, UK
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  • Mofid Ibraheim MRCOG DFFP,

    Locum Consultant in Obstetrics and Gynaecology
    1. Harrogate and District NHS Foundation Trust, Lancaster Park Road, Harrogate HG2 7SX
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  • Seema Bagtharia MRCOG DFFP,

    Clincal Fellow in Obstetrics and Gynaecology
    1. Southend Hospital NHS Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY
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  • Rahim Haloob FRCOG

    Consultant Obstetrician and Gynaecologist, Corresponding author
    1. Basildon University Hospital, Nethermayne, Basildon SS16 5NL, UK
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Basildon University Hospital, Nethermayne, Basildon SS16 5NL, UK Email: rhaloob@googlemail.com

Abstract

Key content

  • Heavy menstrual bleeding remains a major problem for some women.
  • Hysterectomy is the leading treatment for this condition but it is recognised to have some serious complications.
  • First-generation endometrial ablation techniques have a steep learning curve and are carried out under hysteroscopic visualisation.
  • Second-generation techniques are simpler and have lower complication rates, lower analgesia requirements and potential for outpatient use.
  • Individual assessment is important in deciding the route and method of treatment for heavy menstrual bleeding, taking clinical factors into consideration.

Learning objectives

  • To know about the various options currently available for endometrial ablation.
  • To learn about the clinical application, advantages and limitations of various methods of endometrial ablation.
  • To be able to make an informed choice when deciding which modality to use.

Ethical issues

  • Intense competition will continue to drive device manufacturers to make claims of effectiveness based on poor-quality evidence. All users have a responsibility to be well informed and to offer evidence-based advice to women.

Please cite this article as: Justin W, Ibraheim M, Bagtharia S, Haloob R. Current minimal access techniques in the treatment of heavy menstrual bleeding. The Obstetrician & Gynaecologist 2007;9:223–232.

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