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Sunday, May 29, 2016

Endometrial Ablation Device Thermachoice No Longer Available

endometrial Ablations are for removing the uterine lining in women with heavy menstrual bleeding, and it is used in women with heavy bleeding due to other gynecologic conditions such as uterine fibroids and uterine polyps. Although Ethicon recalled its  Gynecare Thermachoice III Uterine Balloon Therapy System silicone catheter, there are still many choices of devices and techniques for endometrial ablations. The “voluntary recall involves only the catheter component of the Gynecare Thermachoice system they found that stability data does not substantiate the labeled two-year shelf life of the product subject to the recall. There is no significant safety issue with the Thermachoice device.” The uterine lining is medically called the endometrium, and it is designed to be the lush baby bed. Originally, or as scientists like to say "ontogenetically" shedding the lining in the way of menstrual blood is to keep it fresh and ready for the next pregnancy. But I like to think of those menstrual periods as the first' blue stick' tests we had. We just needed that firm signal once our roles changed from ready to have a baby to baby present. So the lining is shed monthly, it's not destroyed permanently in the 'natural' premenopausal state. Of course we go back far enough in time women didn't actually have many of those shedding episodes at all. Women in cave times had about 20 menstrual cycles in their life, and now we have about 400. They were pregnant, they were breast feeding, they were malnourished, and no periods. Then physicians came up with a thought. Gynecologists noting that when women after severe infections got scaring and damage that wasn't reversible, modern technology took those lemons and made lemonade! The purposeful creation of a useless lining that would just be scar tissue and not something that could be shed.  The technique of ablation takes that shedding a bit farther, it destroys the ability to regenerate. When and why to have the procedure has also evolved.
The surgery can be performed by manually remove the tissue with a rollerball or rollerblade aimed through the hysteroscope and attached to heat, and those were the first technologies used. Now we have several ways of doing the surgery include the Minerva device NovaSure, , the HydroThermAlate HTA or a cryosurgery device. From women in the past who only had this done as a "last resort" to women having this as their first line treatment for unwanted bleeding. TeLinde's Gynecologic (one of the leading gyno books) text says "there has been significant disagreement regarding the appropriate indications for this procedure," and we'll mull that one over later. Are we trying to say here that women shouldn't have control over their bodies? We wouldn't be hinting that its' actually not up to us to say when to just say NO to your menstrual periods? WWYIC say....(insurance company)? ACOG since their position paper in 2007 says:
  • Endometrial ablation is indicated for the treatment of menorrhagia or patient-perceived heavy menstrual bleeding in pre-menopausal women with normal endometrial cavities who have no desire for future fertility.
  • The presence of anemia or failure or intolerance of medical therapy are important considerations but should not be construed as prerequisites for the procedure.
Well, first when you are considering having an ablation, be sure there is no contraindication, like a cancer of the lining, a polyp, or infection. Also some women with polyps and fibroids may be treated with other or additional techniques. And how anemic are you is another consideration before having the procedure. Women with sight anemia will tolerate the surgery well in many cases, severe anemia may need to be treated first. Make sure your pap is current. But after that, lets sit down Gyno to Girl, and Gab.

1 comment:

  1. A reader asks: I've been searching the internet for someone that might offer me some relief or answer to my problems. I'm a 45 year old woman who had an ablation and had my tubes tied on 11/18/2015. Ever since these procedures I have been struggling with a few problems that no one has been able to solve. After the procedures I had the typical smell that accompanied the after effects from the ablation. What has been something that should have gone away, has not. I've been struggling with a smell ever since. I saw my doctor a total of eight times in the six months following the procedures. I'm a healthy woman and have never needed to go to my gynecologist more than once a year in the past. My doctor has not provided any solution for my problem other than to say I show no signs of infection. I'm going out of my mind with this. My partner has confirmed the smell every time I've asked and it's ruining our sex life. He has been wonderful don't get me wrong but, I've become so self conscious about it, it's not worth it to me anymore. On top of having this horrendous smell, within the last 8-10 months I've experienced the excruciating pains in my abdomen that honestly stop me in my tracks. Also, I've consistently been gaining weight but, it seems to be gathering in my stomach. Ive always had a flat stomach and taken care of myself, this has me stumped. I have had my hormones checked by my regular physician and I'm not pre menopausal. Along with all of these problems I have next to no energy for anything let alone, to do the things I love. My regular physician has put me on daily antidepressants to try and help. So far, nothing has changed. I should mention, my gynecologist gave me a gel and pills to try to get my Ph back in line thinking that was the problem and she gave me birth control pills. I've since been taken off of them. I had never heard of the two diagnoses that you mentioned so I'm hoping you may be a blessing. Could you please offer some suggestion I can mention? This surgery has ruined my life, it's all I think about. Thank you in advance for anything you might be able to offer.

    I generally associate chronic odor with infection, and more likely a vaginal problem than an uterine problem. Only examination and testing can accurately determine what infection this might be.

    ReplyDelete

Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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