LETTER TO THE EDITOR

Endometrial thermoablationfor treatment of menorrhagia

Acta Obstet Gynecol Scand 2003; 82: 1155. # Acta Obstet GynecolScand 82 2003

Sir,It has come to our attention that in the article by

Dr Vihko and coworkers (Endometrial thermoablation fortreatment of menorrhagia: comparison of two methods inoutpatient setting. Acta Obstet Gynecol Scand 2003; 82:269–74), certain points concerning the CavatermTM systemand its use may be misleading. The original Cavaterm sys-tem in this study uses a circulating fluid of glycine 1.5%(nonconductive) heated to a target temperature of 75 �C fora 15-min period. A pressure of 200–220 mmHg should bemaintained throughout the treatment. The correct combin-ation of pressure, temperature and time is essential for thesuccess of the Cavaterm treatment. Optimal pressure is a keyfactor in the success rate and in particular in the amenorrhearate as it ensures a reduction in the blood flow in the targettissue; otherwise the treatment is less than optimal. When thecorrect pressure of 200–220 mmHg is used in correctlyselected patients, the Cavaterm’s pure amenorrhea rate is58–68% (1, 2).

Patient selection is also of the utmost importance. Wall-sten Medical SA recommends hydrosonography or hystero-scopy prior to the Cavaterm to rule out any cavityanomalies. Ultrasound may miss cavity anomalies thatcould inhibit the balloon from lying optimally against theentire endometrium.

Sophie Belanger and Adam El Din

References

1. Mettler L. Long-term results in the treatment ofmenorrhagia and hypermenorrhea with a thermalballoon endometrial ablation technique. JSLS 2002;6: 305–9.

2. Hawe JA, Phillips G, Chien P, Erian J, Garry R.Cavaterm thermal balloon ablation for the treatmentof menorrhagia. Br J Obstet Gynaecol 1999; 106:1143–8.

Address for correspondence:Sophie BelangerWallsten Medical SABox 2036Avenue Riond-Bosson 14CH-1110 Morges 2Switzerland

# Acta Obstet Gynecol Scand 82 (2003)

Acta Obstet Gynecol Scand 2003: 82: 1155 Copyright # Acta Obstet Gynecol Scand 2003

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Gynecologica ScandinavicaISSN 0001-6349