Endometrial Thermal Balloon Ablation in Women with Previous Cesarean Delivery: Pilot Study

Study Objective: To evaluate the safety and efficacy of thermal balloon ablation in the management of menorrhagia in women with history of cesarean delivery. Design: Descriptive study (Canadian Task Force classification II-2). Setting: Tertiary care university hospital. Patients: One hundred sixteen premenopausal women with dysfunctional uterine bleeding were offered endometrial thermal balloon ablation. This group included 26 women who had previously delivered via cesarean section (CS): 11 women with 1 CS, 8 women with 2 CS, 4 women with 3 CS, 2 women with 4 CS, and 1 woman with 5 CS. Intervention: Endometrial thermal balloon ablation. Measurements and Main Results: One hundred thirteen procedures were completed successfully; in 3 women, the procedure could not be completed. There were no major immediate operative complications. Sixteen patients (13.8%) required further gynecologic interventions after ablation: hysterectomy in 15, and dilation and curettage in 1. This included 13 women (14.4%) in the group with no previous CS and 3 women (11.5%) in the group with previous CS. Conclusion: Within the limitations of this preliminary study, endometrial thermal balloon ablation seems to be a possible therapeutic option for treatment of dysfunctional uterine bleeding in women with previous cesarean delivery.