2495 A Retrospective Review of Outpatient Endometrial Ablation Using Minitouch for Treatment of Heavy Menstrual Bleeding

Abstract

Study Objective To determine the outcomes of using Minitouch endometrial ablation as outpatient treatment for heavy menstrual bleeding (HMB) at an established ambulatory gynecology center in a UK teaching hospital. Design Retrospective cohort study. Setting Procedures were performed as outpatient at Central Treatment Suite at Royal Stoke University Hospital, as per department-approved protocol by one of six gynecology consultants. Patients were reviewed from 4 months post-op at consultation or by telephone. Patients or Participants Between March 2017 and March 2019, 35 patients with HMB who opted for outpatient endometrial ablation received the treatment. Interventions Minitouch without/with intracervical local anesthesia. Diagnostic outpatient hysteroscopy +/- endometrial sampling was performed immediately before treatment procedure confirming suitability. Where present, intrauterine device was removed before ablation. Patients were not selected for timing of their menstrual cycle and received no endometrial pre-treatment. Measurements and Main Results In 24 months, 35 patients received treatment. Average patient age was 46 (range 31-55). One patient was nulliparous, 9(26%) had previous caesarean section, 30(86%) received previous treatment for HMB. Utero-cervical length ranged from 6-10cm. Histology confirmed normal endometrium in all cases. Procedure was well tolerated overall with no failure of equipment. Average treatment time was 145s (Range 33-229s). Vasovagal episode was the only observed peri-operative complication (2/35, 5.7%) requiring conservative management. No uterine perforation occurred. No patient required emergency hospital admission post-op. To date, 22 patients were reviewed. Average time to follow-up was 4.9 months. 91% reported satisfactorily improved bleeding patterns including amenorrhea or oligomenorrhoea (14/22, 64%) and less HMB (6/22, 27%). 9% reported same or worsened bleeding requiring further management. Conclusion With its flexibility and smaller size over other devices minimizing the need for cervical dilatation and patient discomfort, the use of Minitouch for outpatient treatment of HMB at our center was shown to be well-tolerated, with high reliability of procedure completion, good safety and efficacy outcomes.