Intraoperative and postoperative lower genital tract changes after global endometrial ablation using the Hydro ThermAblator® device

ObjectiveTo identify any heat transfer areas in the lower genital tract during a Hydro ThermAblator® (HTA) (BEI Medical Systems) procedure and to characterize the changes in the cervix that occur in the immediate weeks after an HTA treatment.DesignA prospective cohort study (Canadian Task Force classification II-3).SettingA university hospital in the United Kingdom.Patient(s)Twenty-five patients with menorrhagia.Intervention(s)All patients underwent global endometrial ablation using the HTA device. Infrared thermal camera imaging of the lower genital tract was performed per-operatively, and colposcopic examinations of the cervix were performed at 2 and 4 weeks after the operation.Main Outcome Measure(s)The surface temperature rise of the cervix and vagina during a procedure.Result(s)Thermal temperature measurements of the lower genital tract in five patients and colposcopic examination at 2 and 4 weeks after the procedure. The maximum temperatures recorded during a procedure were those of the cervix, reaching 36.5°C. Colposcopic images at 2 weeks showed that 15% of patients had a whitish discoloration of the cervix. At 4 weeks, the appearance of the cervix was normal.Conclusion(s)This study shows that during an HTA treatment cycle using a bivalve speculum to visualize the cervix, no area of the lower genital tract reaches a temperature at which thermal damage may occur. A whitish change in the cervix at 2 weeks is normal, and the lower genital tract should appear normal 4 weeks after the procedure.