2892 Minitouch Outpatient Endometrial Ablation for Heavy Menstrual Bleeding - The Way Forward!

Abstract

Study Objective We have been carrying out Minitouch Outpatient ablation at two hospitals since 2015. We share our experience of 179 cases carried out between 2015-2018. Design Patients with heavy menstrual bleeding are offered Minitouch ablation if they have completed family and if medical management options have failed. Setting One district general hospital, one community hospital. Patients or Participants 20% Patients had significant comorbidities, such as body mass index >50, severe pulmonary hypertension and cardiac disease. Interventions All selected patients are given information leaflets and analgesia, and nurse contact numbers to discuss any queries. We carry out Transvaginal Ultrasound scan on all patients and endometrial biopsy unless already done prior to the procedure. Hysteroscopy is performed on patients with structural abnormalities, such as polyps or fibroids, when detected on pelvic ultrasound scan. Patients are instructed to have pre-procedure analgesia at home (Diclofenac, Ibuprofen, Paracetamol) and Entonox (inhaled nitrous oxide) is offered during the procedure. Patients received standard Minitouch treatment. Energy customization features have been used for optimum patient comfort since 2017. Measurements and Main Results No complications were reported. Full energy dose was not delivered in three cases due to patient discomfort. Mean pain scores were 6/10 (intra-procedure) and 1/10 (post-procedure). Overall Success rate was 86% (154/179) with amenorrhea rate of 29%. 18 (10%) patients received further treatments – 2 Gonadotropin-releasing hormone analogue, 7 Repeat Minitouch ablation and 9 Hysterectomy. 31 patients treated using energy customization features had increased comfort and an overall success rate of 93.5% (29/31). Conclusion Minitouch Outpatient ablation without anesthesia, sedation or paracervical block is a safe procedure with high success rates. Customization features enhanced patient comfort without affecting clinical outcomes.