Al-Ibrahim Baraa Lukman Humo, Husaynei Ahmed Jasim Al
Department of Obstetrics and Gynecology, College of Medicine, Mosul University, Mosul, Iraq.
Gynecol Minim Invasive Ther. 2022 May 4;11(2):100-104. doi: 10.4103/GMIT.GMIT_147_20. eCollection 2022 Apr-Jun.
The objective of this study was to determine the efficacy of modified thermal balloon ablation using Foley's catheter in the treatment of heavy menstrual bleeding (HMB).
Twelve patients with HMB aged 35-55 years underwent modified thermal balloon ablation using Foley's catheter. Patients were selected after complete clinical evaluation and investigations. The procedure was undertaken in the operation theater under general anesthesia/intravenous sedation. Three cycles of modified thermal balloon ablation using Foley's catheter were performed to ablate the endometrium. The time given to each cycle was 7 min. All the cycles were performed in the same setting. The main outcome measures that were studied were reduction in the menstrual flow, the need for further treatment, and relief of dysmenorrhea if present. Outcome measure regarding reduction in menstrual flow was statistically analyzed using Fisher's exact test. Statistical significance was determined at a level of < 0.05.
Eighty-two percent of patients experienced a reasonable reduction in menstrual blood flow at 3-month follow-up. Eighteen percent observed no change in bleeding pattern and needed further treatment after failure of the procedure. Forty-two percent of patients complained of minor side effects such as cramp lower abdominal pain and fever. Rupture of balloon during the procedure occurred in only one case (8%).
Modified thermal balloon ablation with Foley's catheter can be a promising management of HMB in resource-poor settings. It is a cost-effective alternative to the original endometrial ablation techniques.
本研究的目的是确定使用 Foley 导管进行改良热球囊消融术治疗月经过多(HMB)的疗效。
12 例年龄在 35 - 55 岁的月经过多患者接受了使用 Foley 导管的改良热球囊消融术。患者在经过全面的临床评估和检查后入选。该手术在手术室全身麻醉/静脉镇静下进行。使用 Foley 导管进行三个周期的改良热球囊消融术以消融子宫内膜。每个周期的时间为 7 分钟。所有周期均在相同条件下进行。研究的主要结局指标包括月经量减少、是否需要进一步治疗以及(若存在)痛经缓解情况。使用 Fisher 精确检验对月经量减少的结局指标进行统计学分析。统计学显著性设定为 < 0.05。
82%的患者在 3 个月随访时月经量有合理减少。18%的患者出血模式无变化,手术失败后需要进一步治疗。42%的患者抱怨有轻微副作用,如下腹部绞痛和发热。手术过程中仅 1 例(8%)发生球囊破裂。
在资源匮乏地区,使用 Foley 导管进行改良热球囊消融术可能是治疗月经过多的一种有前景的方法。它是原始子宫内膜消融技术的一种经济有效的替代方法。