Monday, October 31, 2005

Novasure Endometrial Ablation

Novasure Endometrial Ablation is a "flame-thrower" amongst the devices for endometrial ablation. It consists of an electrode with a sheath at the end; in the beginning of the procedure, the sheath is placed through the cervix. The electrode then expands and conforms to the shape of the uterine cavity. The device tests whether there is any rupture of the cavity and will not turn on if there is one. (As a safety measure, Novasure will turn itself off if 50 ohms of resistance occurs.)

Next, a small quantity of CO2 inflates the uterus so that the device is placed properly. If everything is OK, a short burst of radiofrequency energy, for no more than 90 seconds, destroys the endometrium, and the whole procedure lasts for less than 5 minutes. The device will also remove the desiccated issue from the cavity. Most patients can go home within an hour of the procedure. Besides speed, the main advantage of the Novasure system is that no preparation of the uterus need be done in advance. With other methods of ablation, the patient must receive several injections of Lupron Depot two months beforehand the scheduled date, the idea being to thin the endometrium so that the ablation can succeed better. One injection costs $400 -- you will need several of them, so it is very expensive. Not only that: it produces many unwanted side-effects, such as hot flushes, sweats etc. The procedure itself must be executed when the patient would not have her usual menstrual cycle.

Contrary to all that, Novasure does not need thinning of the endometrium, so there is no need for preparation and costly injections, and it can be done at any time of the woman's menstrual cycle.

For the rest of this article please see:

http://www.how-to-avoid-hysterectomy.com/novasure.html

Thermal Balloon Ablation

Thermal Balloon Ablation was invented to rectify the shortcomings of the first generation of endometrial ablation procedures. Hysteroscopic endometrial resection and ablation proved themselves successful in up to 70-90% of cases of heavy menorrhagia, but the former has at least two disadvantages:

-- the surgeon must have an excellent training in the method, and

-- serious complications may occur. Amongst them are: fluid overload, uterine perforation, infection, haemorrhage, thermal injuries, and even death.

Empirical data show that various ablation techniques, for instance, roller-ball and Nd Yag laser, had the rate of postoperative complication less than 4.4%, which is lower then for the hysteroscopic endometrial resection.

Thermal Balloon Ablation Made a Debut in 1994

In 1994 Neuwirth et al. introduced a thermal uterine balloon therapy system. The results achieved with it are comparable with the hysteroscopic endometrial resection, except that the skills the operator must possess are significantly smaller. The uterine thermal balloon ablation does not require endometrial visualisation, distending solutions, high energy sources, and almost never a cervical dilatation. The rate of postoperative complications for balloon ablation is about 3%, while the operative time is significantly shorter. The procedure can be done under local anesthesia in an outpatient clinic, which means the operative room can be used less.

For the rest of this article see:

http://www.how-to-avoid-hysterectomy.com/thermal-balloon-ablation.html