| Abstract [eng] |
Relevance of the problem, aim and objectives. Heavy menstrual bleeding is a prevalent gynecological issue that has a significant impact on a woman‘s quality of life. There are various medical and surgical interventions, including combinations of both, that can be used to manage this condition. One of the surgical approaches is the thermal balloon endometrial ablation. A significant number of randomized controlled trials have been reported in the scientific literature comparing different second-generation endometrial ablation techniques with one another and with alternative treatments for menstrual bleeding. The objective of this study is to conduct a systematic review and assess the safety and effectiveness of thermal balloon endometrial ablation in comparison with other treatment modalities. Material and methods. A literature search was conducted in four electronic databases: Pubmed, EBSCO, Springerlink, Cochrane library. The following keywords were used for article search: ,,Endometrial thermalablation“, ,,Endometrial thermal ablation“, ,,Heavy menstrual bleeding and ablation“, ,,thermal balloon endometrial ablation”. Articles published between 2012 and 2022 were included in the study. Results. A total of 1305 articles were identified through searches in four electronic databases: Pubmed, EBSCO, Springerlink and Cochrane library. The keywords used were ,,Endometrial thermal ablation“, ,,Endometrial thermalablation“ and ,,Heavy menstrual bleeding and ablation“. The articles included in the review were published between 2012 and 2022 and were selected based on inclusion and exclusion criteria, resulting in total of seven articles. All studies were randomized controlled trials involving 1214 patients. 750 patients underwent thermal balloon endometrial ablation, 227 – radiofrequency ablation, 157 – microwave ablation, 50 – chemoablation and 30 were in the levonorgestrel – releasing intrauterine system group. The results showed that the frequency of amenorrhea after the procedure increased over time and varied across different studies. Six months after the treatment, frequency of amenorrhea after thermal balloon endometrial ablation ranged from 10.2% to 56%, while frequency of eumenorrhea ranged from 60% to 80.9% one year after treatment. However, amenorrhea was achieved more frequently after radiofrequency, microwave ablation and the levonorgestrel – releasing intrauterine system. All studies investigating changes in dysmenorrhea, premenstrual syndrome, and quality of life after endometrial thermal ablation showed positive changes. The most common complication after thermal balloon ablation was endometritis, which ranged from 5% to 13%. Conclusions. This systematic review provides evidence that supports the effectiveness and safety of endometrial thermal ablation as a treatment option for heavy menstrual bleeding. The review suggests that a substantial number of women who undergo this procedure experience either amenorrhea or eumenorrhea. Furthermore, they benefit from a decrease in premenstrual syndrome and dysmenorrhea symptoms, and an improvement in the quality of life. |
