Observational case reports of intra- and postoperative ultrasound monitoring of uterine balloon ablation.

Uterine balloon ablation (UBT) is an established treatment of women with menorrhagia. Success rates in terms of amenorrhoea following UBT vary between about 15 and 40%. The aim of these case reports was to attempt to explain some of the reasons behind the low amenorrhoea rate as well as the variation seen in outcome. This was facilitated by intraoperative ultrasound observation of the position of the heater element within the uterine cavity, including its proximity to the endometrial walls and the direction of microbubbles produced by the heater element. These findings were then correlated with postoperative ultrasound findings and clinical outcome. The position of the balloon catheter within the uterine cavity varied and we hypothesise that this may have an effect on outcome. A thin postoperative endometrium on ultrasound signifies successful ablation, yet is not always associated with a cessation of troublesome menorrhagia, nor patient satisfaction.