Utility of in-office endometrial ablation: a prospective cohort study of endometrial ablation under local anesthesia

To determine tolerability of in-office endometrial ablation under local anesthesia and the rate of adverse events in the first 2 postoperative weeks.

The study was a prospective cohort single group study.

Ablation was performed on 148 patients under deep parametrial block using dilute mepivacaine and oral anxiolysis. No patient requested the procedure be stopped due to pain, but 1 requested intraoperative reinjection of anesthetic. No patient required admission due to pain. No serious adverse events were noted intraoperatively or in the first 2 weeks following the procedure. The most common adverse event at follow-up was bacterial vaginosis in 16 of 143 (11%) of the evaluable cohort. Five patients were seen after the first 2 weeks, without complications, but were therefore excluded from the study. Patient satisfaction was assessed at 2-week follow-up visit in the 143 evaluable cohort. A total of 130 of 143 patients (90%) reported being "Very Satisfied", 13 (9.1%) reported being "Satisfied" and none were "Unsatisfied".

Endometrial ablation can be performed successfully in the physician's office under local anesthesia and oral anxiolysis with low patient pain scores, high tolerability and high patient satisfaction. Serious adverse events were not encountered when performed by properly trained practitioners.