Gynecare Thermachoice

Gynecare Thermachoice is a form of endometrial ablation, which is a procedure that permanently destroys the inner lining of the uterus (endometrium) to stop or reduce excessive menstrual bleeding. This procedure can be performed as an outpatient or with an overnight stay.
The Gynecare Thermachoice represents a simple surgical procedure and consists of a disposable balloon catheter that is inserted through the neck of the uterus (cervix) and into the uterine cavity. The catheter is connected to a controller console, which inflates the balloon with fluid and heated to 87 degrees Celsius for eight minutes to destroy the uterine lining. The whole procedure lasts only 30 minutes.

Women who have heavy menstrual bleeding should consider the endometrial ablation with Gynecare Thermachoice if:

  1. The heavy flow affects their quality of life.
  2. Do not want to take long term medications or they do not respond to medical therapy.
  3. Do not have other problems (such as large fibroid, ovarian cyst or malignancy) that require a hysterectomy.
  4. Have no further desires to get pregnant.

It has been estimated that up to 58% of women treated for heavy menstrual bleeding by hysterectomy might be suitable for endometrial ablation.

Preparation for treatment

  1. Perform a diagnostic hysteroscopy to evaluate the intra-uterine cavity.
  2. A biopsy of the uterine lining may be needed to exclude cancer prior to endometrial ablation.
  3. A recent Pap smear should be done and must be normal.
  4. Pre-medication may be given for four to six weeks to thin out the endometrium prior to the procedure. This will make the ablation easier and more successful.
    Alternatively, the procedure can be performed immediately following the cessation of the monthly menstruation.

This procedure is not suitable for women with the following conditions:

  1. Women who still desire to have more children.
  2. Active vaginal, cervical or pelvic infections.
  3. Cancerous or pre-cancerous condition of the uterus.
  4. Weakness of the uterine muscle wall, usually from previous major uterine surgery

Complications: Bleeding, tearing or puncturing of the womb and infection. (The overall complication rate is much lower compared to the removal of the uterus)

Post-operative period:

  1. Anesthetic side effects are nausea, dizziness for about 24 to 48 hours.
  2. The recovery is normally quick and many women can return to normal activities within a few days.
  3. Slight crampy pain in the pelvic region may be experienced for several hours after the procedure.
  4. Light blood loss may occur for a few days.
  5. There will be watery vaginal discharge for two to three weeks.
  6. Future pregnancy is not advisable after an endometrial ablation. Therefore, it is essential for the couple to use a reliable contraception method after the procedure.

Risks: Complication risks are extremely low, approximately .1% ( 1 in 1000 ) especially when compared to a very invasive hysterectomy with 5-10% of patients with complications.

Success Rate: 93% of patients have experienced a significant reduction in menstrual blood flow.