Balloon thermal endometrial ablation

NICE interventional procedures guidance [IPG6] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on balloon thermal endometrial ablation.

The Medicines and Healthcare Products Regulatory Agency (MHRA) has issued safety notices relating to this procedure (Reference Nos. (MDA [1998] SN 9812 and MDA [1999] SN 1999(18) ). For full details click here.

This guidance has been withdrawn as the use of this procedure is now covered in the Clinical Guideline on Heavy menstrual bleeding, (www.nice.org.uk/cg44). NICE has no plans to carry out further assessment of this procedure under the Interventional Procedures Programme.

  • Description

    This treatment is used to treat heavy menstrual periods, also known as menorrhagia.

    Menorrhagia is a very common problem. In 2000/2001, about 45,000 hysterectomies and 17,000 therapeutic endoscopic uterine procedures were carried out in England (Hospital Episode Statistics; ungrossed for missing data; Department of Health). About half of these are likely to be for heavy menstrual bleeding.

    Hysterectomy has been the traditional treatment for women with menorrhagia that has not responded to medical treatment. Minimally invasive procedures to destroy the lining of the uterus (endometrium) may reduce complications and recovery time compared with hysterectomy.  They involve destroying the endometrium using lasers, radiofrequency waves, electrocautery, microwaves, heated saline, or a heated balloon.

    Balloon thermal endometrial ablation is one of these minimally invasive procedures. It involves inserting a balloon into the uterine cavity through the cervix. The surgeon inflates the balloon with a pressurised solution, which is then heated to destroy the endometrium. It can often be carried out using local anaesthesia on a day-case basis.

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