Gynaecology Thrissur

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Thermal Ablation

 Women nearing menopause quite often have excessive uterine bleeding.  When there is no obvious structural 

abnormality in the uterus or ovaries to account for this, it is called dysfunctional uterine bleeding.

Normally, it is amenable to medical therapy.  When the bleeding becomes intractable or the patient gets fed up of 

medications, in the past, the only recourse was hysterectomy,or removal of the uterus.  Of late many alternative 

treatment modalities have come up for treatment of intractable uterine bleeding.  One of them is endometrial ablation.

 Endometrium can be ablated using hot solutions.  This is called Thermal ablation.

Thermal ablation at Elite Mission Hospital: I have been doing Thermal ablation in my unit for the past 7 years

  using ordinary urinary catheters . The urinary catheter with a bulb at one end is inserted into the uterine cavity

 and the bulb inflated using boiling hot water. The cost of therapy is considerably reduced by not using the

 company made thermal ablators.

What it involves for the patient: The procedure is done usually under local anaesthesia and intramuscular

 sedation.  Patients who request anaesthesia are given general anaesthesia.  By and large all women who

 have undergone the procedure under local anaesthesia  have not expressed dissatisfaction at not being 

given general anaesthesia. The procedure is done on a day care basis.  It takes about 45 minutes by the

 method I do.  Patients complain of uterine cramps after the procedure, which can be controlled with

 medications. They normally go home by evening.

Follow up: I used to contact the patients over telephone every 6 months and have ascertained that

 80% of patients are satisfied with the procedure. Some of them have no periods(Amenorrhoea),

 decreased periods (Oligomenorrhoea) or normal periods following the procedure. The recurrence is

 usually in patients who have concomitant fibroids.






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