Table of Contents

1. Epidemiology of menorrhagia; 2. Diagnosing menorrhagia; 3. The role of ultrasound in investigating menorrhagia; 4. The role of hysteroscopy in investigating menorrhagia; 5. Current treatment options: an evidence based approach; 6. Classification of endometrial ablation techniques; 7. Hysteroscopic endometrial laser ablation techniques; 8. Hysteroscopic electrosurgical - resection and rollerball; 9. Cryotherapy: uterine endometrial cryoablation with ultrasound visualisation; 10. Cryotherapy: endometrial cryoablation; 11. Thermachoice I: balloon ablation; 12. Thermachoice II: balloon ablation; 13. CAVATERM thermal balloon ablation; 14. MENOTREAT balloon ablation; 15. Vesta-distensible multi-electrode balloon endometrial ablation; 16. NOVASURE endometrial ablation; 17. MEA: microwave endometrial ablation; 18. ELITT: endometrial laser intra-uterine thermal therapy; 19. Hydrothermablation (BEI); 20. The ENABL hydrothermal system for endometrial ablation; 21. Photodynamic therapy; 22. Mirena intra-uterine system; 23. Bilateral uterine artery embolisation; 24. Avoidance of complications in hysteroscopic surgery; 25. Future research and recommendations.

Promotional Information

It allows the reader to easily compare instruments and techniques, with a comprehensive overview of the subject.

Reviews

During the last decade many techniques for endometrial ablation to treat menorrhagia have been developed. Some are difficult to learn, requiring considerable skill and often expensive equipment. Data are available regarding the success rates and complications with the original, often technically demanding techniques. Newer techniques and devices are intended to simplify the surgery and to decrease the severity and frequency of complications, although often they have significant cost implications. For the working clinician the proliferation of techniques and devices is confusing and it is difficult to evaluate them when often the source of advice and assistance is a representative of the equipment manufacturer. This book brings together a group of authors who are pre-eminent in their field. The initial chapters address the epidemiology and diagnosis of menorrhagia, the use of ultrasound and hysteroscopy, and the classification of ablation techniques. Fifteen methods of endometrial ablation are discussed, each in its own chapter written by the original developer of the technique or by an author with acknowledged experience and reputation. Each technique is described, potential advantages and disadvantages discussed and reference made to relevant published literature. Chapters on the use of Mirena, uterine artery embolisation, and avoiding surgical complications are all useful contributions. The book is easy to read and well organised and is a good resource for those wishing to review an approach to the assessment and management of menorrhagia. It also provides the more experienced gynaecologist with a useful appraisal of the several techniques of endometrial ablation and their value.