Thermachoice thermal baloon therapy – a 10-year-experience

Authors: L. Hrazdírová;  D. Kužel;  D. Tóth;  Z. Žižka
Authors‘ workplace: Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. A. Martan, DrSc.
Published in: Čes. Gynek.2009, 74, č. 2 s. 124-129
Category: Original Article


To evaluate the effectivness of a global method of endometrium ablation – Thermachoice (Gynecare; Johnson & Johnson) baloon therapy in treatment of excessive uterine bleeding. Our 10-year-long- experience is presented.

Retrospective study.

Department of Gynecology and Obstetrics, First faculty of Medicine, Charles University and General Teaching Hospital, Prague.

Methodology and results:
109 patients were treated in our depatment from November 1997 till the end of the year 2007. The pacients were contacted personally, over the phone and by sending questinnaires. 92 women (84.4%) were included into the evaluation group after twelve month and after 5 years there were 54 women. The group was mostly formed by seriosly polymorbid patients. The average age was 41.6 years. In the twelve-month-follow-up there were 38 percent amenorrheic, five years later there were 63 percent of them. 13 women (14%) ended with hysterectomy – two pacients without any connection with the operation. In 3 cases there was a therapeutic cycle failure, because the acquired intrauterine pressure was not reached. In one case of the monstrous obese woman, after a longer period form the operation there was a carcinoma of the endometrium found out. Two women after the termoablation became pregnant: the first one non-voluntarily, she decided for the arteficial abortion and then the hysterectomy, the second one, despite the fact, that she had been fully informed, underwent the IVF therapy and at the age of 37 she delivered by the Cesarian section in the 36-week-old pregnancy the healthy girl weighing 2900 gramms. With one patient – a young woman the operation was combined with uterine artery embolisation (UAE) – and that is why she was excluded. 51.5% of all operations were perfomed without general anestesia.

There was no serious complication in the observed group.


The big advantage of the second generation ablation methods is the possibility to realise the operation without the general anestesia and with the minimum discomfort for the patient. Another favourable circumstance was the shorter determined operating time and lower percentage of complications in comparison with the first generation methods. The big benefit is mainly for the seriously polymobid pacients.

Key words:
endometrial termoablation, menorrhagia, global ablation method, Thermachoice, thermal baloon therapy.


1. Amso, NN. Clinical and health service implications of second generation endometrial ablation devices. Curr Opin Obstet Gynecol, 2006, 18, p. 457-463.

2. Amso, NN., Fernandez, H., Vilos, G., et al. Uterine endometrial ballon therapy for the tratment of menorrhagia: long-term multicentre follow-up study. Hum Rep, 2003, 18, 5, p. 1082-1087.

3. Bedner, R., Rzepka-Gorska, I. Hysteroscopy with directed biopsy versus dilatation and curretage for diagnosis of endometrial hyperplasia and cancer in peromenopausal women. Eur J Gynaecol Oncol, 2007, 28, 5, p.400-402.

4. Bongers, MY., Mol, BW., Dijkhuizen, FP., Brolmann, HA. Is balloon ablation as effective as endometrial elektroresection in the treatment of menorrhagia? J Laparoendosc Adv Surg Tech A, 2000, 10, p. 85-92.

5. Clark, TJ., Gupta JK. Outpatient thermal ballon ablation of the endometrium. Fertil Steril, 2004, 82, 5, p. 1395-1401.

6. Cooper, J., Brill, A., Fulop, T. Is endometrial pretratment necessary in NovaSure 3-D endometrial ablation? Gynaecol Endosc, 2001, 10, p. 179-182.

7. El-Nashar, SA., Hopkins, MR., Feitoza, SS., et. al. Global endometrial ablation for menorrhagia in women with bleeding disorders. Obstet Gynecol, 2007, 109, 6, p. 1381-1387.

8. Farrugia, M., Kamala, M., Lewis, RS. Ballon endometrial ablation under hysteroscopic control of septate uterus comlicated by postcesarean scar defekt. J Minim Invasive Gynecol, 2008, 15, p. 220-222.

9. Foote, M., Rouse, A., Gil, KM., et. al. Successful pregnancy following both endometrial ablation and uterine artery embolization. Fertil Steril, 2007, 88, 6, p. 15-17.

10. Garside, R., Stein, K., Wyatt, K., et al. Microwave and thermal ballon ablation for heavy mentrual bleeding: a systematic review. BJOG, 2005, 112, p. 12-23.

11. Gervaise, A., Fernandez, H., Capella-Allouc, S., et al. Thermal baloon ablation versus endometrial resection for the treatment of abnormal uterine bleeding. Hum Reprod, 1998, 14, p. 2743-2747.

12. Gervaise, A., de Tayrac, R., Fernandez, H. Contraceptive information after endometrial ablation. Fertil Steril, 2005, 84, 6, p. 1746-1747.

13. Gurtcheff, SE., Sharp, HT. Complications associated with global endometrial ablation: the utility of the MAUDE database. Obstet Gynecol, 2003, 102, p. 1278-1282.

14. Hare, AA., Olah, KS. Pregnancy following endometrial ablation: a review article. J Obstet Gyn, 2005, 25, 2, p. 108-114.

15. Higham, JM., O’Brien, PMS., Shaw, RW. Assesment of mentrual blood loss using a pictorial chart. Br J Obstet Gynaecol, 1990, 97, p. 734-739.

16. Holub, Z., Kužel, D., et al. Minimálně invazivní operace v gynekologii. Praha: Grada, 1. vyd., 2005, p. 210-217.

17. Kir, K., Hanlon-Lundberg, KM. Successful pregnancy after thermal balloon endometrial ablation. Obstet Gynecol, 2004, 103, p. 1070-1073.

18. Kleijn, JH., Engels, R., Bourdrez, P., et al. Five-year follow up of randomised controlled trial comparing NovaSure and ThermaChoice endometrial ablation. BJOG, 2008, 115, 2, p. 193-198.

19. Lethaby, A., Hickey, M., Garry, R. Endometrial destruction techniques for heavy menstrual bleeding. Cochrane Database Syst Rev, 2005, 4, CD001501.

20. Loffer, FD. Endometrial ablation in patients with myomas. Curr Opin Obstet Gynecol, 2006, 18, p.391-393.

21. Loffer, FD., Grainger, D. Five-year follow up of patients participing in a randomised trial of uterine ballon therapy versus rollerball ablation for treatment of menorrhagia. J Am Assoc Gynecol Laparosc, 2002, 9, p. 429-435.

22. March, F., Bekker, H., Duffy, S. A survey of women’s views of Thermachoice endometrial ablation in the outpatient versus day case setting. BJOG, 2008, 115, 1, p. 31-37.

23. March, F., Thewlis, J., Duffy, S. Thermachoice endometrial ablation in the outpatient setting, without local anesthesia or intravenous sedation: a prospective cohort study. Fertil Steril, 2005, 83, 3, p. 715-720.

24. Meyer, WR., Walsh, BW., Grainger, DA., et al. Thermal balloon and rollerball ablation for treat menorrhagia: a multicenter comparisation. Obstet Gynecol, 1998, 92, p. 98-103.

25. Neuwirth, RS., Loffer, FD., Trenhaile, T., et. al. The incidence of endometrial cancer after endometrial ablation in a low-risk population. J Am Assoc Gynecol Laparosc, 2004, 11, 4, p. 492-494.

26. Rubin, G., Wortman, M., Kouides, PA. Endometrial ablation for von Willebrand disease-related menorrhagia- experience with seven cases. Haemophilia, 2004, 10, p. 477-482.

27. Toth, D., Gervaise, A., Kuzel, D., et al. Thermal balloon ablation in patients with multiple morbidity: 3- years follow-up. J Am Assoc Gynecol Laparosc, 2004, 11, 2, p. 236-239.

28. Valle, RF., Valdez, J., Wright, TC., et al. Concomitant Essure tubal sterilisation and Thermachoice endometrial ablation: feasibility and safety. Fertil Steril, 2006, 86, 1, p. 152-158.

29. Watermeyer, SR., Nix, B., Amso, NN. A randomised controlled study of two preoperative preparation protocols prior to endometrial baloon ablation in women with menorrhagia. In: Proceedings of the RCOG 6th International Scientific Meeting- Improving the health of Women: Lessons from Past, Hope for Future. Cairo, 2005, p. 48.

30. Zarek, S., Sharp, HT. Global endometrial ablation devices. Clin Obstet Gynecol, 2008, 51, 1, p. 167-175.

31. Zurawin, RK., Pramanik, S. Endometrial balloon ablation as a therapy for intractable uterine bleeding in an adolescent. J Pediatr Adolesc Gynecol, 2001, 14., p. 119-121.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 2

2009 Issue 2

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account