Should diagnostic hysteroscopy be performed routinely following thermal balloon endometrial ablation? A case report of thermal bowel injury and literature review

Abstract

Should diagnostic hysteroscopy be performed routinely following thermal balloon endometrial ablation? A case report of thermal bowel injury and literature review Hazem Al-Mandeel1,2, * 1Department of Obstetrics and Gynecology, College of Medicine, King Saud University, 999088 Riyadh, Saudi Arabia 2 King Saud University Medical City, King Saud University, 999088 Riyadh, Saudi Arabia *Correspondence: halmandeel@ksu.edu.sa (Hazem Al-Mandeel) DOI:10.31083/j.ceog.2021.02.2128 This is an open access article under the CC BY-NC 4.0 license (https://creativecommons.org/licenses/by-nc/4.0/). Submitted: 02 May 2020 Revised: 05 July 2020 Accepted: 06 July 2020 Published: 15 April 2021 Although thermal balloon endometrial ablation (TBEA) is an eȞfective and easy technique, it can cause serious complications, including bowel injury, if perforation occurs. In this paper, a case of thermal bowel injury caused by the Thermablate Endometrial Ablation System is presented with a review of previous literature on such complications. Based on this case and expert recommendations, users are advised to follow established protocols, including hysteroscopy just prior to the insertion of the TBEA catheter to exclude prior uterine perforation from the uterine sound or curettage, and an additional hysteroscopy aȻter completion of the ablation as the final step to ensure that a perforation has not occurred. Keywords Menorrhagia; Heavy menstrual bleeding; Endometrial ablation; Thermal balloon ablation; Bowel burn; Bowel injury