Document Detail


Thermal balloon endometrial ablation therapy induces a rise in uterine blood flow impedance: a randomized prospective color Doppler study.
MedLine Citation:
PMID:  11244659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the possible hemodynamic changes in uterine blood flow using transvaginal color Doppler ultrasonography after thermal balloon endometrial ablation therapy. STUDY DESIGN: Prospective randomized study. PATIENTS AND METHODS: Twenty-seven pre- and post-menopausal women with either menorrhagia or endometrial hyperplasia (no sign of atypia) were randomized to receive either thermal balloon ablation therapy (n = 13) or gestagen therapy (n = 14). In the gestagen therapy group, a 3-month period of medroxy-progesterone acetate (10 mg/day) was given to premenopausal women during cycle days 15-24 and it was given to postmenopausal women continuously. Thermal balloon endometrial ablation therapy was carried out on cycle days 3-8. All the color Doppler measurements were also carried out on cycle days 3-8. Flow waveforms were obtained from the main branch of the uterine arteries, from arcuate arteries and from a subendometrial spiral artery. Doppler flow parameters were used for subsequent statistical analysis. The measurements took place before the initiation of treatment, on the first postoperative day (thermal ablation group only), and 1 month and 6 months after initiation of the study. RESULTS: No within-group or between-group differences were detected until the time of the last measurement 6 months after initiation of the treatment. Between the two randomized groups, the pulsatility index (PI) was significantly higher in the thermal ablation group in all three arteries in comparison with the gestagen group, in which no change in the PI took place. In the thermal ablation group, a significant rise from the pretreatment level was observed in the PI in the uterine arteries and in the spiral artery 6 months after the therapy. CONCLUSION: Thermal balloon endometrial ablation therapy induces a rise in uterine blood flow impedance, but not until 6 months after the treatment. The rise in impedance may be due to fibrosis in the uterine cavity which thermal balloon therapy has been shown to produce.
Authors:
I Järvelä; A Tekay; M Santala; P Jouppila
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  17     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-03-13     Completed Date:  2001-06-14     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  65-70     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulu, Finland. ijarvela@cc.oulu.fi
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation
Catheter Ablation*
Endometrial Hyperplasia / surgery*
Endometrium / surgery*
Female
Humans
Medroxyprogesterone Acetate / therapeutic use
Menorrhagia / surgery*
Postmenopause
Premenopause
Progesterone Congeners / therapeutic use
Time Factors
Ultrasonography, Doppler, Color*
Uterus / blood supply*,  ultrasonography
Chemical
Reg. No./Substance:
0/Progesterone Congeners; 71-58-9/Medroxyprogesterone Acetate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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