Archives of Gynecology and Obstetrics

, Volume 280, Issue 4, pp 599–602

Second generation endometrial ablation techniques: an audit of clinical practice

  • Chendrimada K. Madhu
  • Joseph Nattey
  • Tahira Naeem
Original Article



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.


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.


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.


Second generation endometrial ablation techniques Microwave endometrial ablation Thermal balloon endometrial ablation Menorrhagia Patient satisfaction 


  1. 1.
    National Institute for health and Clinical Excellence (2007) Heavy menstrual bleeding—clinical guideline 44. NICE, LondonGoogle Scholar
  2. 2.
    Lethaby A, Hickey M, Garry R (2005) Endometrial destruction techniques for heavy menstrual bleeding. Cochrane Database Syst Rev 4:CD001501PubMedGoogle Scholar
  3. 3.
    Gynecare Thermachoice® Instructions for use Gynecare worldwide, Division of Ethicon inc., A Johnson and Johnson Company, New BrunswickGoogle Scholar
  4. 4.
    Jack SA, Cooper KG (2005) Microwave endometrial ablation: an overview. Rev Gynaecol Pract 5:32–38. doi:10.1016/j.rigp.2004.06.005 CrossRefGoogle Scholar
  5. 5.
    Vilos GA, Edris F (2007) Second generation endometrial ablation technologies: the hot liquid balloons. Best Pract Res Clin Obstet Gynaecol 21(6):947–967. doi:10.1016/j.bpobgyn.2007.03.022 PubMedCrossRefGoogle Scholar
  6. 6.
    Garside R, Stein K, Wyatt K, Round A, Price A (2004) The effectiveness and cost-effectiveness of microwave and thermal balloon endometrial ablation for heavy menstrual bleeding: a systematic review and economic modeling. Health Technol Assess 8(3):1–155Google Scholar
  7. 7.
    Sambrook AM, Parkin DE (2005) Endometrial ablation—a review of second generation techniques. Rev Gynaecol Pract 5:166–171. doi:10.1016/j.rigp.2005.03.001 CrossRefGoogle Scholar
  8. 8.
    McGurgan P, O’Donovan P (2007) Second generation endometrial ablation—an overview. Best Pract Res Clin Obstet Gynaecol 21(6):931–945. doi:10.1016/j.bpobgyn.2007.03.015 PubMedCrossRefGoogle Scholar
  9. 9.
    Hodgson DA, Feldberg IB, Sharp N, Cronin N, Evans M, Hirschowitz L (1999) Microwave endometrial ablation: development, clinical trials and outcomes at three years. Br J Obstet Gynaecol 106(7):684–694PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Chendrimada K. Madhu
    • 1
    • 2
  • Joseph Nattey
    • 1
  • Tahira Naeem
    • 1
  1. 1.Department of Obstetrics and Gynaecology, Calderdale Royal HospitalHuddersfield Royal Infirmary Calderdale and Huddersfield NHS TrustHalifaxUK
  2. 2.11A, Upland Crescent, OakwoodLeedsUK

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