Microwave endometrial ablation: patients' experiences in the first 3 months following treatment

The aim of this study was to investigate patients' experiences in the first 3 months following microwave endometrial ablation (MEA) for menorrhagia as well as the suitability of local anaesthesia (LA) versus general anaesthesia (GA) for these procedures. We carried out a cross-sectional questionnaire survey of 173 patients at 3 months after treatment with MEA. All were treated between September 1997 and December 1999. The setting was a small free-standing hospital day unit equipped with a minor operating theatre. Interventions were pretreatment with danazol or goserelin, followed by endometrial ablation with microwaves under GA or LA. Of the 173 patients, 98 (57%) were treated under GA, and 75(43%) under LA. The return of questionnaires was high in both groups (90% for GA and 84% for LA) and all procedures were completed with the planned anaesthetic. Commonly reported symptoms were immediate postoperative pain (61%), abdominal pain in the following weeks (75%), vaginal discharge (87%), vaginal bleeding (74%) and vaginal dryness. Reported symptoms were usually mild and not requiring medical intervention, e.g. in 124 patients (71%), postoperative pain was either absent or mild with no analgesics required. Only 4% had severe pain requiring a single dose of opiate analgesia. The results were similar in both groups. Sixty-nine per cent (104 patients) had no pain 1 week after treatment. This increased to over 90% by the end of the third week. Results were similar in those treated under LA (83% and 96%, respectively). There was early return to normal daily activity (70% by 1 week and 95% by 3 weeks). Reported symptoms were usually mild and not severe enough to warrant consultation of their doctor or the hospital. There were no blood transfusions or hysterectomy within the first 3 months of treatment. We conclude that MEA is well tolerated by patients. Reported side effects are usually minor. LA is comparable to GA and seems to have potential benefits.