This document discusses uterine balloon therapy as an alternative to hysterectomy for treating heavy menstrual bleeding. It provides information on how the procedure is performed using a balloon catheter to ablate the endometrial lining in 8 minutes. Studies show uterine balloon therapy has success rates of 95% in reducing bleeding, requires only a brief hospital stay, and carries a low risk of complications compared to other procedures. It is presented as a minimally invasive treatment option especially for patients who are poor surgical candidates or wish to avoid hysterectomy.
8. Dilemma!! of Treatment
Aim - Quality Personal life
- Family life
- Preserve the feminity of a women
- ↓ Frequent leave from office
Age
Severity
Fertility
9. Treatment of Heavy Periods
Individualized
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age
need for contraception
desire to retain uterus
Nature and severity of complaints
presence of any pelvic pathology
outcome of previous treatment
cost of treatment
time away from work
13. NICE guideline (Jan 2007)
management of heavy menstrual bleeding
• If future childbearing is desired
LNG – IUS is the first line intervention
• If future child bearing is not
desired
Endometrial ablation
16. Day Care Procedure
• Definitive solution for patients
• Minimally Invasive
• High safety profile
• Requires minimal training
• Clinically proven (90-97%)
• Can be performed under LA
• Cost Effective
See to Believe it
17. FEAT
FIRST GENERATION ENDOMETRIAL ABLATION
TECHNIQUES
(Hysteroscopic Techniques)
• Long learning curve
•Succes rate 85%
• Re-surgery up to 30% .
•LO
Given up by most experts
21. Therma choice
• A balloon tipped
catheter is positioned
into the uterine cavity
and filled with fluid
that is heated to 87
degrees centigrade
• Ablation cycle takes
8 minutes.
22. Extensive Safety/Feasibility Study:
In-Vivo +2 Million
• Mean peak serosal temperature: 36.1 + 1.6
• Deep endometrial and superficial myometrial
injury in all areas
• Deepest myometrial injury: 3.4 mm
• In no uterine cornu was depth > 2.0 mm
25. Uterine Balloon Therapy
• 95 % success rate
• 50 % amenorrhic at 1
year
• Affects fertility
Pre-Ablation
Post Ablation
Use of effective contraception
following procedure is must
30. Factors Affecting
Failure Rate decreases
• Pre- operative medical therapy
Danazol /gnRH - G
• Post Operative therapy with injection
Depo-provera 3 monthly for 4-6 injections
(95 to 99%)
31. INTERNATIONAL MULTI-CENTER STUDY
INTERNATIONAL MULTI-CENTER STUDY
PATIENTS WITH AT LEAST 24 MONTH FOLLOW-UP
PATIENTS WITH AT LEAST 24 MONTH FOLLOW-UP
8 min treatment; >150 mmHg Start Pressure
Amenorrhea /spotting
36%
22%
Normalperiods
Hypomenorrhea
38%
Minimal or no
reduction in
menses 4.0%
32. > OVER 20,00,000
procedures worldwide
We Have Largest
No. of Cases of UBT in India
Updated on 1/9/2013,N - 1304
39. Uterine Balloon Therapy is thus a new
horizon to your patient and yourself.
Once family is completed
BE BOLD, WALK ALONG NEW
PATHS
EXPERIENCE IT YOURSELF
Benefits of hysterectomy. There are women out there who want amenorrhea and will be satisfied with nothing less. After understanding and accepting the balanced risks, benefits, and alternatives, those patients may be more appropriate candidates for hysterectomy than for any type of endometrial ablation, since no type of ablation can guarantee amenorrhea.
WHY SHOULD’NT A HYSTERECTOMY BE AVOIDED IF THE BENEFIT CAN BE PROVIDED TO A GOOD NO, OF PATIENTS BY A SAFER ALTERNATIVE TT MODALITY COZ HYSTERECTOMY DOES CARRY RISKS OF ANAESTHESIA ETC