Kapur K, Joneja G S, Biswas M
Classified Specialist (Obstetrics & Gynaecology) and Endoscopic Surgeon, Army Hospital (R & R), Delhi Cantt.
Consultant (Obstetrics & Gynaecology), Army Hospital (R & R), Delhi Cantt.
Med J Armed Forces India. 2007 Jan;63(1):36-9. doi: 10.1016/S0377-1237(07)80105-5. Epub 2011 Jul 21.
Menorrhagia is a common problem in women of reproductive age. Its aetiology in the absence of organic pathology, hormonal or haematological disorders remains largely unknown. Traditional medical therapy may not be beneficial in the long run. Hysterectomy for this condition is an invasive over treatment. First generation endometrium ablation techniques aimed at destroying the endometrium, were associated with life threatening complications. The second generation endometrial ablation techniques like uterine thermal balloon therapy have reduced these problems.
Fifty patients were selected for the procedure between 2002 and 2005. The patients qualified for the procedure if they had completed their family, had normal pelvic ultrasound findings, benign endometrial histology, normal PAP smear and clinically a normal size or bulky uterus.
50% patients were in the age group of 35-45 years. 28(56%) procedures were done under local anaesthesia and 22(44%) under general anaesthesia. The patients were followed up for a period of 3 to 29 months (median 16 months). Seven(14%) had amenorrhoea and 40(80%) had normal periods or hypomenorrhoea. Three(6%) patients continued to have menorrhagia and were considered failures. 94% patients were satisfied with the procedure and there were no complications in this series. Conclusions : Uterine balloon therapy is a simple, safe and effective method for the treatment of menorrhagia in selected patients.
月经过多是育龄期女性的常见问题。在没有器质性病变、激素或血液系统疾病的情况下，其病因在很大程度上仍不明确。从长远来看，传统药物治疗可能并无益处。针对这种情况进行子宫切除术属于过度侵入性治疗。第一代旨在破坏子宫内膜的子宫内膜消融技术，与危及生命的并发症相关。第二代子宫内膜消融技术，如子宫热球囊疗法，减少了这些问题。
2002年至2005年期间选择了50例患者进行该手术。如果患者已完成生育、盆腔超声检查结果正常、子宫内膜组织学良性、巴氏涂片正常且临床检查子宫大小正常或增大，则符合该手术条件。
50%的患者年龄在35 - 45岁之间。28例（56%）手术在局部麻醉下进行，22例（44%）在全身麻醉下进行。对患者进行了3至29个月的随访（中位时间16个月）。7例（14%）出现闭经，40例（80%）月经正常或月经量减少。3例（6%）患者持续月经过多，被视为治疗失败。94%的患者对该手术满意，本系列中无并发症发生。结论：子宫球囊疗法是治疗特定患者月经过多的一种简单、安全且有效的方法。
