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Intraoperative and postoperative lower genital tract changes after global endometrial ablation using the Hydro
Martin Farrugia1, Sarah Y Hussain
1Department of Obstetrics and Gynaecology, Whipps Cross University Hospital, London, United Kingdom. martin@farrugia.demon.co.uk
Objective:
To identify any heat transfer areas in the lower genital tract during a Hydro ThermAblator (HTA) (BEI Medical Systems) procedure and to characterize the changes in the cervix that occur in the immediate weeks after an HTA treatment.
Design:
A prospective cohort study (Canadian Task Force classification II-3).
Setting:
A university hospital in the United Kingdom.
Patient(S):
Twenty-five patients with menorrhagia.
Intervention(S):
All patients underwent global endometrial ablation using the HTA device. Infrared thermal camera imaging of the lower genital tract was performed per-operatively, and colposcopic examinations of the cervix were performed at 2 and 4 weeks after the operation.
Main Outcome Measure(S):
The surface temperature rise of the cervix and vagina during a procedure.
Result(S):
Thermal temperature measurements of the lower genital tract in five patients and colposcopic examination at 2 and 4 weeks after the procedure. The maximum temperatures recorded during a procedure were those of the cervix, reaching 36.5 degrees C. Colposcopic images at 2 weeks showed that 15% of patients had a whitish discoloration of the cervix. At 4 weeks, the appearance of the cervix was normal.
Conclusion(S):
This study shows that during an HTA treatment cycle using a bivalve speculum to visualize the cervix, no area of the lower genital tract reaches a temperature at which thermal damage may occur. A whitish change in the cervix at 2 weeks is normal, and the lower genital tract should appear normal 4 weeks after the procedure.
