Tactile Electrosurgical Ablation in Cases of Dysfunctional Uterine Bleeding
Condition: Dysfunction Uterine Bleeding
MeSH terms: Uterine Hemorrhage; Metrorrhagia; Hemorrhage
Study type: Interventional
Phase: Phase 2

Summary: 
      Abnormal uterine bleeding (AUB) is any alteration in the pattern or volume of menstrual blood
      ﬂow and heavy menstrual bleeding affects up to 30% of women at some time during their
      reproductive years. Abnormal menstruation can be due to conditions such as pregnancy
      complication uterine fibroids and adenomyosis, but in a large proportion of cases, the
      etiology is unclear, a condition generally referred to as dysfunctional uterine bleeding
      (DUB). Treatment options for DUB include symptomatic medical treatment or surgery,
      traditionally hysterectomy.

      Hysteroscopically guided endometrial ablation methods have been shown to be effective and
      safe alternatives to hysterectomy for management of DUB. These methods require particular
      skills and experience and a long learning curve to be performed effectively and safely.

      Through the past three decades DUB patients in Assiut university hospital were treated with
      either electrosurgical ablation or hysterectomy. When faced with hysteroscopic challenges
      during transcervical resection of the endometrium or rollerball coagulation, we used to shift
      to thermal balloon as backup method . However, expensive uterine balloon could not
      infrequently be afforded because of financial constrains and limited health resources .
      Therefore, another method was used as backup for hysteroscopic failures. It was first tried
      via insulating the conventional double-ended uterine curette then through a specially
      designed tactile electrosurgical ablation (TEA) probe.The technique of TEA is largely similar
      to the dilatation and curettage procedure both principally and practically. Hence, the basic
      requirements for its performance are the general awareness with electrosurgical principles
      and adequate experience in performing dilatation and curettage. TEA is done by specially
      designed tactile diathermy probe that carried the job of electrosurgical ablation without
      hysteroscopy or distension media first in an experimental session that clearly clarified the
      reproducibility of the depth of thermal damage and safety of the tactile electrosurgical
      ablator . Thereafter, TEA was successfully performed with satisfactory short and medium term
      outcomes for ten cases with DUB during an active, relentless bleeding attack. TEA is done
      under laparoscopic monitoring.

      The aim of the present work is to present TEA as a simple, inexpensive, novel backup approach
      for treatment of DUB.
    


Intervention name(s): Tactile electrosurgical ablation probe; Hysteroscopic endometrial ablation
Intervention type(s): Device; Device
Other intervention name(s): Transcervical resection of the endometrium
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Dysfunction uterine bleeding; Hysteroscopic endometrial ablation; Tactile endometrial ablation; Hysteroscopic difficulties; Quality of life; Satisfaction