Global endometrial ablation devices

Since 1997, the US Food and Drug Administration has approved 5 global endometrial ablation (GEA) devices for the minimally invasive treatment of idiopathic menorrhagia. These include a variety of modalities to ablate the endometrium, including thermal balloon, circulated hot fluid, cryotherapy, radiofrequency electrosurgery, and microwave energy. Level I evidence is available to support high subjective satisfaction rates regardless of GEA method. There is a wide range of amenorrhea rates (13.9% to 55.3%) among GEA methods. Complication rates associated with GEA procedures are generally low when performed by physicians familiar with these devices, working under standard protocols compared with some of the major complications seen after these devices have been used by a broader range of physicians without study protocols. Adherence to patient selection and protocols is recommended.