| Abstract [eng] |
Objective: Heavy menstrual bleeding is one of the most common gynecologic disorders among women of reproductive age and has a significant impact on their physical, psychological, and social well-being. Although international guidelines recommend medical therapy as the first-line treatment, it may prove ineffective, poorly tolerated, or unsuitable due to comorbid conditions or concerns related to hormonal therapy. Minimally invasive, uterus-preserving surgical interventions, such as endometrial balloon ablation, may represent an important therapeutic alternative; however, in clinical practice, its consideration and use remain limited. The aim of this study was to evaluate the effectiveness and safety of endometrial balloon ablation in a selected group of women with heavy menstrual bleeding. Methods: We conducted an observational study during the period 2022–2023, involving the collection and analysis of clinical data and patients' subjective evaluations of treatment outcomes at Vilnius University Hospital Santaros Klinikos. A total of 31 women presenting with heavy persistent menstrual bleeding were enrolled in the study and 28 women were included in final data analysis. All patients enrolled in our study had either experienced unsuccessful prior conservative medical treatment, had contraindications to first-line treatment due to comorbidities, had personal reasons for declining hormonal treatment, or wished to preserve the uterus. Results: Endometrial ablation using the Lina Librata endometrial ablation system was performed in 28 patients. At 12 months of follow-up, treatment success was achieved in 20 patients (71.43%; 95% confidence interval [CI]: 51.3–86.8), with procedure-related amenorrhea in eight out of 20 patients (40%; 95% CI: 19.1–63.9). Treatment failure occurred in 28.57%; 95% CI: 13.2–48.6 (8/28) of patients; consequently, some patients declined further treatment for personal reasons, whereas others required or requested repeated ablative treatment or an alternative surgical intervention. Conclusion: Endometrial balloon ablation demonstrated a favorable safety and efficacy profile, and no complications occurred during the study period, including among patients considered to be at increased risk of bleeding. The procedure significantly contributes to uterus-preserving treatment strategies and represents an appropriate alternative for women for whom medical therapy is ineffective or unsuitable, or who decline hysterectomy. |
