One patient, two uteri, two endometrial ablations: case report of thermal balloon ablation in uterine didelphys.
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OBJECTIVE: To describe the clinical application and outcomes after endometrial ablation with ThermachoiceIII (Ethicon, Somerville, NJ) in a patient with uterine didelphys with heavy menstrual bleeding. DESIGN: Case report. SETTING: Inner-city community obstetrics and gynecology clinic. PATIENT(S): A 44-year-old Hispanic woman, gravida 3, para 0, with three spontaneous abortions. INTERVENTION(S): The patient underwent diagnostic hysteroscopy, gynecologic dilation and curettage, and endometrial ablation with ThermachoiceIII. MAIN OUTCOME MEASURE(S): Menstrual pattern at 3 months postoperatively, as either amenorrhea (complete lack of menstrual flow), hypomenorrhea (scant or minimal flow lasting <5 days, requiring only light pads), or failure (flow similar to pretreatment state or requiring any other therapy), as well as dysmenorrhea reduction from baseline. Hemoglobin value at 3 months was compared with baseline. RESULT(S): At 3 months, hypomenorrhea was maintained. Bleeding days were 10 per month at baseline and 2 per month after therapy. Visual analogue scale score for dysmenorrhea was 8 at baseline and 2 (mean) at study end. Hemoglobin was 8.9 g/dL at baseline (preoperatively) and 11.1 g/dL at 3 months postoperatively. CONCLUSION(S): Successful conservative therapy of menorrhagia seems possible with thermal balloon ablation in a uterine didelphic patient.
